Health care worker exposed to HIV should be evaluated within hours (rather than days) after their exposure in order to allow early initiation of PEP. The exposed Health care workers should be counselled and tested for HIV at baseline (i.e., to establish infection status at the time of exposure). In case of refusal to test, PEP should not be started or should be discontinued. For purposes of considering HIV PEP, the evaluation also should include information about medications the exposed person might be taking and any current or underlying medical conditions or circumstances (i.e., pregnancy, breast feeding, or renal or hepatic disease) that might influence drug selection. Hepatitis B vaccination should be considered after any large volume needle-stick injury.