The Centers for Disease Control and Prevention (CDC), on behalf of the U.S. Public Health Service (PHS), has released the 2025 Guidelines for the Management of Occupational Exposure to Human Immunodeficiency Virus (HIV) and Recommendations for Postexposure Prophylaxis (PEP). The guidelines are published in Infection Control & Hospital Epidemiology (ICHE), the journal of the Society for Healthcare Epidemiology of America (SHEA).

960px-HIV-infected_T_cell_(6813384933) (1)

Source: NIAID

Scanning electromicrograph of an HIV-infected T cell.

The 2025 guidelines reaffirm many of the practices recommended in the 2013 PHS Guidelines while incorporating major updates that reflect the latest evidence and therapeutic advances. The recommendations provide practical, evidence-based guidance for healthcare personnel (HCP) following occupational exposures to HIV.

Key updates include:

  • New antiretroviral regimens for PEP based on low rates of side effects and convenient dosing schedules.
  • Shortened duration of follow-up HIV testing after occupational exposure.
  • Elimination of routine follow-up laboratory testing for antiretroviral drug toxicity when baseline testing is normal and no signs or symptoms of toxicity develop during PEP.
  • Considerations for PEP in cases where the source patient has an undetectable viral load.
  • Guidance for healthcare personnel already on pre-exposure prophylaxis (PrEP) at the time of occupational exposure.

 “These updated guidelines reflect the latest evidence and therapeutic advances, helping ensure that healthcare personnel receive timely, safe, and effective care after potential HIV exposure,” said Dr. David J. Weber, President SHEA Board of Trustees and Associate Editor, ICHE.  “They also recognize the changing landscape of HIV prevention, including the increasing use of PrEP among healthcare providers.”

The 2025 PHS Guidelines continue to emphasize the importance of prompt evaluation and initiation of PEP following occupational exposures, while streamlining follow-up protocols to reduce unnecessary testing and burden on healthcare personnel.

The full guideline, “2025 U.S. Public Health Service Guidelines for the Management of Occupational Exposure to Human Immunodeficiency Virus and Recommendations for Postexposure Prophylaxis in Healthcare Settings,” is available here: https://doi.org/10.1017/ice.2025.10254.

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