JPAC Joint United Kingdom (UK) Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee

Pre- and Post-Exposure Prophylaxis for HIV prevention

Obligatory

Must not donate if:
a) The donor has taken oral Pre-Exposure Prophylaxis (PrEP) or Post-Exposure Prophylaxis (PEP) in the previous three months.

b) The donor has received an injection for PrEP in the previous two years.

Assess any donor using PrEP or PEP for blood safety risks relating to sexual activity.

Discretionary

If:

  • it is over three months since the donor last used oral PrEP or PEP, and
  • it is over two years since the donor last received an injection for PrEP, and
  • there is no other blood safety risk,

accept.

See if Relevant

Blood Safety Entry
HIV
Non-consented Exposure to Human Body Fluids

Additional Information

The use of Pre-Exposure Prophylaxis (PrEP) to prevent HIV is increasing. Individuals taking PrEP are unlikely to be eligible to donate due to criteria within the blood safety entry. However, PrEP is also available via private prescription and/or online pharmacies and may be used by individuals who would not otherwise be deferred.

PrEP is normally given in tablet form but longer-acting injectable PrEP e.g. cabotegravir (Apretude®) may also be used in individuals who are not suitable for oral medication. Cabotegravir injections are given on an 8-weekly basis to ensure adequate HIV protection. Low levels of cabotegravir can be detected for many months in treated individuals, even after injections have been stopped.

Use of PrEP may interfere with testing for HIV by delaying seroconversion or giving unclear results in a positive donor. For this reason, it is important that donors who have taken oral PrEP in the previous three months, or injected PrEP in the previous two years, are not accepted to donate, even if they do not have another blood safety risk.

Post-Exposure Prophylaxis (PEP) has a similar mechanism of action to PrEP and may also interfere with testing results. In the UK PEP is prescribed to people who have been exposed to someone who may have HIV. This includes sexual activity or a needle stick injury. Donors who have received PEP will usually be ineligible to donate for the same reason they were given PEP.

If the underlying reason for taking PrEP or PEP warrants a longer deferral period, this should be applied.

Reason for change

Addition of a two-year deferral for recipients of injectable PrEP.

Update Information

This entry was last updated in:
WB-DSG Edition 203 Release 77