Global data about the prescribing frequency of post-exposure prophylaxis (PEP) in both occupational and non-occupational settings are limited.
In the UK, 8765 reports of significant occupational exposures have been reported to the Health Protection Agency between 1997 and 2018, with just one HIV seroconversion due to a percutaneous exposure from a hollow-bore needle in 1999.[6]UK Health Security Agency. Bloodborne viruses: eye of the needle. Dec 2021 [internet publication].
https://www.gov.uk/government/publications/bloodborne-viruses-eye-of-the-needle
No further cases have been reported to date. In the US, the Centers for Disease Control and Prevention established a national non-occupational HIV PEP surveillance registry, but clinician reporting rates were low.[4]Centers for Disease Control and Prevention; US Department of Health and Human Services. Updated guidelines for antiretroviral postexposure prophylaxis after sexual, injection drug use, or other nonoccupational exposure to HIV - United States, 2016. May 2018 [internet publication].
https://stacks.cdc.gov/view/cdc/38856
There is evidence of increased awareness and uptake of PEP in some settings, particularly following promotional programmes with the involvement of trained medical providers.[7]Minas B, Laing S, Jordan H, et al. Improved awareness and appropriate use of non-occupational post-exposure prophylaxis (nPEP) for HIV prevention following a multi-modal communication strategy. BMC Public Health. 2012 Oct 25;12:906.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3503851
http://www.ncbi.nlm.nih.gov/pubmed/23095456?tool=bestpractice.com
[8]Draughon JE, Sheridan DJ. Nonoccupational postexposure prophylaxis for human immunodeficiency virus in Sub-Saharan Africa: a systematic review. J Forensic Nurs. 2011 Jun;7(2):89-96.
http://www.ncbi.nlm.nih.gov/pubmed/21635680?tool=bestpractice.com
[9]Arend E, Maw A, de Swardt C, et al. South African sexual assault survivors' experiences of post-exposure prophylaxis and individualized nursing care: a qualitative study. J Assoc Nurses AIDS Care. 2013 Mar-Apr;24(2):154-65.
http://www.ncbi.nlm.nih.gov/pubmed/22835505?tool=bestpractice.com
However, general awareness of the availability of non-occupational PEP remains poor; a cross-sectional survey in the US (July 2014 and May 2015) reported 1 in 8 healthcare providers were unaware of PEP.[10]John SA, Quinn KG, Pleuhs B, et al. HIV post-exposure prophylaxis (PEP) awareness and non-occupational PEP (nPEP) prescribing history among US healthcare providers. AIDS Behav. 2020 Nov;24(11):3124-31.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7508835
http://www.ncbi.nlm.nih.gov/pubmed/32300991?tool=bestpractice.com
In Spain, a study of non-healthcare professionals receiving rapid HIV testing found that only 22% of participants were aware of the availability of non-occupational PEP.[11]Fernández-Balbuena S, Belza M, Castilla J, et al. Awareness and use of nonoccupational HIV post-exposure prophylaxis among people receiving rapid HIV testing in Spain. HIV Med. 2013 Apr;14(4):252-7.
http://www.ncbi.nlm.nih.gov/pubmed/23088284?tool=bestpractice.com
Similarly low rates of PEP have been reported in low- and middle-income countries.[12]Hugo JM, Stall RD, Rebe K, et al. Knowledge, attitudes and beliefs regarding post exposure prophylaxis among South African men who have sex with men. AIDS Behav. 2016 Dec;20(suppl 3):350-6.
http://www.ncbi.nlm.nih.gov/pubmed/27539310?tool=bestpractice.com
[13]Ajayi AI, Ismail KO, Adeniyi OV, et al. Awareness and use of pre-exposure and postexposure prophylaxes among Nigerian university students: findings from a cross-sectional survey. Medicine (Baltimore). 2018 Sep;97(36):e12226.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6133481
http://www.ncbi.nlm.nih.gov/pubmed/30200145?tool=bestpractice.com