What is the immediate action in the event of a needlestick exposure to HIV?

• A. Begin post-exposure prophylaxis immediately.
• B. Wash the site and report exposure.
• C. Test the healthcare worker only after 6 weeks.
• D. Wait for 72 hours before taking any action.

Answer: (B)

When a needlestick exposure occurs, the immediate priority is to decontaminate and notify so that exposure management can begin without delay. Clean the exposed area with soap and running water right away and flush any mucous membranes or eyes with clean water if contact occurred. This first step helps reduce the viral burden at the entry site and gets the process started.

After cleansing, report the exposure to the supervisor or occupational health so a formal assessment can be done. This report triggers evaluation of the exposure type, the source patient’s HIV status if known, and whether post-exposure prophylaxis is indicated. A baseline HIV test for the exposed worker is typically obtained, and follow-up testing is arranged according to protocol.

Post-exposure prophylaxis is important and should be started as soon as possible if the risk assessment supports it, but it comes after initial cleansing and reporting. It is not appropriate to wait or to delay action for testing to occur later, and waiting for 72 hours to take any action would miss a critical window for prevention. Immediate action plus prompt evaluation and potential initiation of PEP provides the best chance to prevent infection, along with later planned follow-up testing at recommended intervals.