A 30-year-old man presents to urgent care 48 hours after he had unprotected sex with a new partner. The partner’s HIV status is unknown, and the patient is now anxious about the risk of HIV infection. He has no significant past medical history and is not currently on any medications. Which of the following would be the most appropriate next steps in the management of this patient?
- Reassure the patient that the risk of HIV transmission is low and recommend monitoring for symptoms over the next few weeks.
- Advise the patient to follow up with his primary care provider and provide no further intervention.
- Recommend immediate testing for HIV and wait for results before deciding on any further care.
- Recommend immediate testing for HIV and initiate a 28-day course of HIV PEP.
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Answer: D. The patient’s presentation falls within the 72-hour window during which PEP is most effective. Given the potential risk of HIV transmission due to unprotected intercourse with a partner of unknown HIV status, it is appropriate to initiate PEP without delay. HIV testing should be ordered and the patient should be advised to see his primary care provider for repeat testing and to complete the course of PEP.
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Last Updated on June 3, 2024
Tracey Davidoff, MD, FACP, FCUCM, has practiced Urgent Care Medicine for more than 15 years. She is Board Certified in Internal Medicine. Dr. Davidoff is a member of the Board of Directors of the Urgent Care Association and serves as Co-Editor-in-Chief of the College of Urgent Care Medicine’s “Urgent Caring” publication. She is also the Vice President of the Southeast Regional Urgent Care Association and a member of the editorial board of the Journal of Urgent Care Medicine. At EB Medicine, Dr Davidoff is Editor-In-Chief of Evidence-Based Urgent Care, and co-host of the Urgentology podcast.
