If you shared a needle, syringe, or other injection equipment, contact a clinician promptly. If it happened within the past 72 hours, seek urgent care now and ask whether HIV post-exposure prophylaxis (PEP) is appropriate. When indicated, PEP should start as soon as possible; do not wait for test results or for information about the other person before seeking care.
What to do right now
- Note when the exposure happened. Record the date and approximate time, and whether you saw blood or shared a needle, syringe, or other equipment used to prepare or inject drugs.
- Get urgent clinical assessment. Go to an emergency department, urgent care, or another clinician able to assess PEP. Say clearly that you shared injection equipment and ask about HIV, hepatitis C (HCV), and hepatitis B (HBV) evaluation.
- Share relevant information if you have it. Tell the clinician what you know about the source person’s HIV or hepatitis status and, for HIV, whether they are known to have a detectable viral load. Do not delay care to find out.
- Bring your own health details. Mention your hepatitis B vaccination history, previous immunity or infection test results, medications, and any relevant health conditions. These can affect the clinician’s recommendations.
This is U.S.-focused general guidance based on CDC recommendations. A clinician must tailor care to the exposure and your circumstances.
HIV: ask about PEP immediately
Sharing needles, syringes, or other injection equipment can expose someone to HIV. CDC’s 2025 nonoccupational PEP (nPEP) recommendations call for starting as soon as possible—ideally within 24 hours and no later than 72 hours after exposure. If prescribed, the course lasts 28 days. PEP is emergency prescription treatment, not an over-the-counter product.
For a blood exposure involving shared injection equipment, CDC recommends nPEP when the source has HIV with detectable viremia or unknown viral suppression. If the source’s HIV status is unknown, a clinician makes the decision case by case; unknown status alone does not establish an individual’s precise risk. When PEP is indicated, the first dose should not be held while laboratory results are pending.
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If more than 72 hours have passed, still seek care. CDC recommends HIV testing, prevention counseling—including discussion of PrEP when relevant—and a follow-up testing plan for people presenting after that window. There may be important care to provide even when PEP is no longer recommended.
HIV testing after the exposure
A test at the first visit establishes a baseline, but a negative result cannot rule out infection from a very recent exposure. For people who start nPEP, CDC’s 2025 guidance specifies the following follow-up schedule. The clinician should choose the appropriate tests and explain any exception.
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| When | Test or action | What it means |
|---|---|---|
| At the initial visit | Baseline HIV testing, as directed by the clinician | Shows status at presentation; it does not exclude acquisition from the just-reported exposure. |
| 4–6 weeks after exposure | Lab-based HIV antigen/antibody test plus diagnostic NAT | Interim follow-up for people beginning nPEP. A clinician may defer this test in the limited circumstance that nPEP began within 24 hours and no doses were missed. |
| 12 weeks after exposure | Final lab-based HIV antigen/antibody test plus diagnostic NAT | CDC’s recommended final follow-up testing for people beginning nPEP. |
The interim-test exception is for a clinician to assess; it is not a reason to skip follow-up on your own. Ask the treating clinician for your exact test dates and how you will receive results.
Hepatitis C: recent exposure may need RNA testing
HCV can spread through shared injection equipment. CDC recommends testing people who currently or previously injected drugs and shared needles, syringes, or other equipment used to prepare drugs. For a possible exposure within the past six months, CDC says HCV RNA nucleic acid testing (NAT) is preferable to relying on an antibody test alone. A positive RNA result indicates current infection and warrants evaluation for treatment.
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The schedule below is CDC’s algorithm for health-care personnel exposed to HCV. It is useful context, but it is occupational guidance—not an automatic protocol for community needle sharing. A clinician should set an individualized plan for a community exposure.
| Stage in CDC occupational guidance | Testing | Scope or condition |
|---|---|---|
| Baseline | Anti-HCV antibody with reflex HCV RNA testing if the antibody is positive | For exposed health-care personnel. |
| 3–6 weeks after exposure | HCV RNA NAT | When follow-up is indicated under the occupational guidance. |
| 4–6 months after exposure | Anti-HCV antibody; reflex RNA if positive | If RNA was negative at the earlier follow-up, under the occupational algorithm. |
In that occupational guidance, follow-up is indicated when the source is HCV RNA positive, anti-HCV positive without known RNA status, or cannot be tested. A clinician assessing a community exposure can use the relevant clinical guidance and your circumstances rather than assuming those source-based criteria apply unchanged.
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Hepatitis B: vaccination and immunity matter
Tell the clinician whether you completed hepatitis B vaccination, have had immunity testing, or have previously had HBV infection. Management depends on both your vaccination or immune status and the source person’s status. CDC’s detailed cited post-exposure table applies to health-care settings; its exact branches should not be assumed to govern a community exposure. The clinician should review your records and apply the guidance appropriate to your situation.
Prevent another exposure and get support
For future injections, use a new sterile needle and new injection equipment every time. A local syringe services program may provide sterile supplies and safe disposal, or connect you to those services. These steps can reduce future exposure; they do not replace medical assessment or testing for the exposure that already happened.
If sharing could happen again, ask a clinician about ongoing HIV prevention, including PrEP where appropriate. Address urgent exposure care first.
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