Recently, a great deal of interest has focused on preventing transmission to uninfected people who are inadvertently exposed by the early administration of antiviral therapy. Because the risk of infection after most isolated exposures is relatively small and the number of patients needed for study would be great, formal studies are difficult to perform. Animal studies and some human experience, however, suggest that post-exposure treatment may be effective. In fact, the current recommendation is that health-care workers who experience a needle stick from an infected person take antiviral medication for four weeks in order to reduce the risk of infection. Guidelines now recommend similar preventive treatment for people with sexual exposures to HIV. Those individuals considering this type of preventative treatment, however, must be aware that post-exposure treatment cannot be relied upon to prevent HIV infection. Moreover, such treatment is not always available at the time most needed and is probably best restricted to unusual and unexpected exposures, such as a broken condom during intercourse. Although regimens with two or three drugs generally are recommended for those exposed in the health-care setting, the best therapy for sexual exposure still is unknown and ideally should be initiated within hours of exposure and certainly within the first several days. Updated guidelines are published and available at http://www.hivatis.org/
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