A healthcare worker sustains a needlestick exposure to HIV. What is the immediate standard protocol?

• A. Wash the site and report exposure.
• B. Begin post-exposure prophylaxis immediately.
• C. Test the healthcare worker only after 6 weeks.
• D. Begin post-exposure prophylaxis as soon as possible within 72 hours and test both participants.

Answer: (D)

Post-exposure management aims to prevent HIV infection by acting fast. The most important step is to start post-exposure prophylaxis as soon as possible within 72 hours of the exposure, because the protective effect is strongest when treatment begins promptly. Alongside this, testing the source patient to determine their HIV status and testing the exposed worker to establish a baseline are essential to guide the decision about PEP and to plan follow-up. After the initial actions, wound care, exposure reporting, and documenting the incident should occur, with follow-up HIV testing at appropriate intervals to detect any seroconversion. In summary, beginning PEP within the 72-hour window and testing both participants together provides the best chance to prevent HIV transmission.