Post-exposure prophylaxis after occupational and non-occupational exposures to HIV: an overview of the policies implemented in 27 European countries

The aim of this survey, which was part of an English-French project support ed try the Commission of the European Communities, was to compare access to HIV post-exposure prophylaxis (PEP) in the occupational and non-occupation al contexts in 27 European countries. A protocol was designed in May 1998 i n collaboration with all country consultants. Data were collected at countr y level by each consultant through interviews, review of local and national recommendations and results of national or local surveys. The final compar ative analysis was carried out from the individual country reports and a re view of the literature. The large majority of European countries have derai led procedures regarding occupational PEP: 20/27 have produced national gui delines, three have adopted the US CDC recommendations and only four have n o official recommendations. Although no standard protocol exists, the more common one is a four-week implementation of a triple combination therapy. I n the context of non-occupational exposure to HIV, only five countries have guidelines with specific recommendations and one country has adopted the C DC recommendations. In the majority of cases (13 countries), PEP is never r ecommended but is only available in a few circumstances, sometimes with maj or limitations. In the last eight countries, such PEP is nor currently avai lable. Although the estimations of HIV transmission risks in occupational a nd non-occupational contexts are really comparables, easy access to PEP aft er accidental sexual or blood exposures is not guaranteed for the general p opulation in the majority of European countries.