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HIV PEP (PEPSE): immediate actions, regimen, and follow-up

A Canadian clinical summary of hiv pep (pepse): immediate actions, regimen, and follow-up, with source-attributed priorities and explicit jurisdiction boundaries.

JurisdictionCanada
Source check2026-08-20
Clinical reviewiatroX editorial team 路 Clinical editorial review 路 reviewed 2026-08-20 路 due 2027-08-20
AudienceHealthcare professionals practising in Canada
This is an iatroX educational summary of named Canada sources, not an official guideline. It does not replace the complete source documents, local policy, specialist advice or clinical judgement. The evidence source is pan-Canadian, but formularies, funded access, referral routes, public-health directions and service availability remain provincial or territorial.

Source and scope

This summary is bounded to the recommendations, population and decisions covered by Canadian guideline on HIV pre- and postexposure prophylaxis: 2025 update. Apply it with the current provincial or territorial pathway where implementation differs.
sources for this section:Canadian HIV PrEP/PEP 2025

Source-attributed clinical priorities

  • Assess exposure type, source likelihood, timing, baseline HIV status and hepatitis and pregnancy considerations immediately.
  • Start post-exposure prophylaxis as soon as indicated without waiting for all results, using the current provincial regimen.
  • Complete interaction review, adherence support and scheduled HIV, renal, hepatic and STI follow-up.
  • Post-exposure prophylaxis is time critical and should start as soon as possible within the Canadian eligibility window.
sources for this section:Canadian HIV PrEP/PEP 2025

Practical assessment and management workflow

1
Document exposure time, body fluid, route, source information, pregnancy and baseline medicines.
2
Perform baseline HIV, hepatitis and STI testing without delaying the first dose when indicated.
3
Select a recommended regimen after renal, liver and interaction review and arrange the full course.
4
Provide adherence support and scheduled repeat HIV and STI testing.
sources for this section:Canadian HIV PrEP/PEP 2025

Safety, red flags and urgent escalation

  • Exposure older than the recommended window still requires testing, counselling and PrEP assessment.
  • If the source is known HIV-positive, obtain urgent specialist information on viral load and resistance without delaying PEP.
  • New symptoms during follow-up require reassessment for acute HIV or medication toxicity.
sources for this section:Canadian HIV PrEP/PEP 2025

Confirm the local pathway before acting

The evidence source is pan-Canadian, but formularies, funded access, referral routes, public-health directions and service availability remain provincial or territorial.
sources for this section:Canadian HIV PrEP/PEP 2025

Source and implementation boundary

Read this educational summary with the linked source, current Canadian product information where medicines are involved, and the applicable provincial or territorial pathway. Local formularies, reporting duties, referral routes and service availability can differ.
sources for this section:Canadian HIV PrEP/PEP 2025

Source documents

Use the linked source documents for complete recommendations, evidence grading, exclusions and implementation detail.

  1. CIHR Pan-Canadian Network for HIV/AIDS and STBBI Clinical Trials ResearchCanadian guideline on HIV pre- and postexposure prophylaxis: 2025 updateaccessed 2026-08-20
    view source
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