Eight percent had conditions exacerbated by work, and the remainder had illnesses from nonoccupational or unknown causes.

Similarly, PEP is not expected to have complete efficacy after nonoccupational exposures.

Postexposure prophylaxis in children and adolescents for nonoccupational exposure to human immunodeficiency virus.

Further guidance on nonoccupational HIV exposure is available (55).

Occupational and nonoccupational exposures to asbestos, Ann.

Persons with a single, recent nonoccupational HIV exposure.

Survey of nonoccupational HIV postexposure prophylaxis in hospital emergency departments.

PEP also is recommended following nonoccupational sexual and injection-drug use--related exposures (24).

The recommendations are intended for nonoccupational exposures and are not applicable for occupational exposures.

Management of possible sexual, injecting-drug use, or other nonoccupational exposure to HIV, including considerations related to antiretroviral therapy.

HIV RNA testing in the context of nonoccupational postexposure prophylaxis.

Although 40,000 new HIV infections occur in the United States each year, relatively few exposed persons seek care after nonoccupational exposure.

In May 2001, CDC convened the second external consultants meeting on nonoccupational post-exposure prophylaxis to review and discuss the available data.

These data indicate that nPEP might sometimes reduce the risk for HIV infection after nonoccupational exposures.

Antiretroviral postexposure prophylaxis after sexual, injection-drug use, or other nonoccupational exposure to HIV in the United States.

Recommendations for nonoccupational (e.g., sexual, pediatric, and perinatal) HIV exposures also have been published previously (4--6).

After a reported sexual, injection-drug use, or other nonoccupational exposure to HIV (55), providers should refer clients for prompt initiation of evaluation, counseling, and follow-up services.

Prophylaxis exists for a limited number of situations: perinatal transmission, acute occupational exposure, and acute nonoccupational (i.e., high-risk sexual or needle-sharing) exposure.

These factors should not be used to determine recommendations for CTR in circumstances in which treatment potential exists (i.e., perinatal transmission and acute occupational or nonoccupational exposure).

Guidelines for the use of antiretroviral PEP in both occupational and nonoccupational settings have been published previously (22--24), but these documents do not specifically address situations involving mass casualties.

In July 1997, CDC sponsored the External Consultants Meeting on Antiretroviral Therapy for Potential Nonoccupational Exposures to HIV.

However, because the majority of nonoccupational exposures do not lead to HIV infection and because the use of combination antiretroviral therapy might reduce further the transmission rate, such occurrences are probably rare.

Decisions regarding the administration of prophylaxis after a mass-casualty event are complex, and drawing direct parallels from existing guidelines regarding prophylaxis against bloodborne pathogens in occupational or nonoccupational settings is difficult.

For further information, consult the respective guidelines on perinatal transmission, acute occupational exposure, and acute nonoccupational exposure (Revised Recommendations for HIV Screening of Pregnant Women,54,55).

Lurie P, Miller S, Hecht F, Chesney M, Lo B. Postexposure prophylaxis after nonoccupational HIV exposure: clinical, ethical, and policy considerations.