Experiences of the National Post-Exposure Prophylaxis Hotline (PEPline): Occupational PEP consultation needs and...

The National Clinician Consultation Center operates the Post-Exposure Prophylaxis Hotline (PEPline), a federally-funded educational resource providing bloodborne pathogen exposure management teleconsultation to US clinicians.

Sixty-seven thousand one hundred nine occupational post-exposure prophylaxis (PEP) consultations (January 2014 to December 2022) were retrospectively analyzed to describe PEPline utilization and common inquiries addressed by National Clinician Consultation Center consultants.

Most calls involved percutaneous incidents (70%); blood was the most common body fluid discussed (60%). Inpatient units were the most common exposure setting (35%) and licensed nursing professionals were the most common category of exposed workers (28%). Of 2,295 calls where workers had already initiated PEP for human immunodeficiency virus (HIV) prevention and time to first dose was known, 9% had initiated HIV PEP within 2 hours of exposure; almost 80% had initiated HIV PEP between 2 and 24 hours; 3% after 24 to 36 hours; 5% after 36 to 72 hours; and 2% after 72 hours. Calls from urgent care providers increased by 10% over time. Overall, more than 90% of callers requested support on risk assessment, including source person testing; other common questions involved PEP side effects and follow-up care.

PEPline consultations can help raise awareness about PEP availability and timely initiation, and reduce stigma by addressing common misperceptions about bloodborne pathogen transmission mechanisms and likelihood, particularly regarding HIV.