In January, the feds cranked out new guidelines for offeringpost-exposure prophylaxis (PEP)—the emergency anti-HIV regimen forfolks likely exposed to the virus within the previous 72 hours. The newrecommendations expand its long-approved use (a triple combo for 28days—hence, mornings after) for so-called occupational accidents, suchas hospital needlesticks to include the far larger number of slipups bycivilians—needle sharing and, especially, high-risk sex. Whilewell-informed doctors and bold city health departments, such as SanFrancisco’s, have offered PEP for unsafe sex since the late ’90s, theCDC’s move is an official stamp of approval, directing medicalproviders to inform at-risk patients of its availability.

“Wesent a press release [announcing the guidelines] through all majormedical media,” says Ronald Valdiserri, MD, CDC deputy director.But  POZ’s randomsampling of top HIV facilities nationwide indicates that the CDC needsto step up its PEP PR because Valdisseri’s memo has largely goneunread, and many providers do not know a PEP pill from a pep cheer.

BeaconClinic in Boulder, Colorado, and El Rio Community Health Center inTucson, Arizona, offered no PEP at all. In Charleston, South Carolina,neither the top ASO nor the health department knew where to get PEP. ASt. Louis HIV clinic provided PEP, but only to people who knew theirpartner was HIV positive. AID Atlanta, Georgia’s biggest ASO, justminutes from CDC headquarters, helpfully redirected POZto two local hospitals, but both offered PEP only to its hospitalemployees. A local health department staffer had never even heard ofPEP.

On the other hand, in New York City, a St. Vincent’s Hospital rep told POZthat all walk-ins can readily get PEP. A Cleveland clinic even said itoffers PEP up to a week after exposure. “I wish all we had to do wasissue guidelines,” Valdiserri says, “but it takes ongoing education.Providers need to take some responsibility, too.”