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Occupational HIV exposure — USMLE Step 3 MCQ

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ModerateAmbulatory Medicine / Primary CareOccupational HIV exposureUSMLE Step 3

A 36-year-old man comes for follow-up after an occupational needle-stick injury from a patient whose HIV status is unknown. The injury occurred 18 hours ago. He washed the area immediately. Baseline HIV antigen/antibody test is negative. Which of the following is the most appropriate next step in management?

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Correct answer: A — Start HIV postexposure prophylaxis now

HIV PEP should be started as soon as possible, ideally within 72 hours, when an exposure is significant and the source is unknown or potentially positive. Source testing should not delay initiation.

Reference: CDC/USPHS Occupational HIV Postexposure Prophylaxis Guidelines