We present the updated British Association for Sexual Health and HIV (BASHH) guidelines for post‐exposure prophylaxis (PEP) to HIV following sexual exposures, occupational exposures and other nonoccupational exposures in the community. This serves as an update to the 2015 BASHH guideline on PEP following sexual exposures and the 2008 Expert Advisory Group on AIDS guidelines on HIV PEP. We aim to provide evidence‐based guidance on best clinical practice in the provision, monitoring and support of PEP for the prevention of HIV acquisition following sexual, occupational and other nonoccupational exposures in the community. The guideline covers when to prescribe PEP, what antiretroviral agents to use and how to manage PEP. This includes (i) evidence of PEP efficacy; (ii) evidence relating to individual‐level efficacy of antiretroviral therapy to prevent the sexual transmission of HIV; (iii) data on the detectable (transmissible) prevalence of HIV in specific populations; (iv) risk of HIV transmission following different types of sexual and occupational exposure; (v) baseline risk assessment; (vi) drug regimens and dosing schedules; (vii) monitoring PEP; (viii) baseline and follow‐up blood‐borne virus testing; (ix) the role of PEP within broader HIV prevention strategies, for example, HIV pre‐exposure prophylaxis (PrEP). The guideline also covers special scenarios such as PEP in pregnancy, breastfeeding and chronic hepatitis B virus infection, and when PEP should be considered in people using HIV PrEP. The guidelines are aimed at clinical professionals directly involved in PEP provision and other stakeholders in the field. A proforma to assist PEP consultations is included. A public consultation process was undertaken prior to finalizing the recommendations.

Calculating standardised mean difference in future RCTs would allow future reviews to be more inclusive of the evidence. The authors suggest more consistent approach for evaluating work-related features in future studies. We recommend that new fit note categories introduced by UK Department of Work and Pension (unfit for all work/return to modified work or work adaptations/return to normal work) would be used to identify different levels of return to work.

AimsTo compare blood transmission through nitrile, single and double layer latex glove materials in simulated needlestick injuries. MethodsExperiments involved nitrile, single and double layer latex gloves. A cutting suture needle was dipped into a specimen of blood and then immediately jabbed through the glove material into a cell containing saline. This process was repeated using the same blood specimen with different glove materials, plus a control experiment with no glove material. Other factors, including the angle, speed and depth of needle penetration, were controlled through the use of a testing machine. Following needle punctures, samples were taken from the suspension contained in each cell and examined under blind conditions. Median red blood cell (RBC) count was used as a measure of the quantities of blood transmitted through the different gloves. ResultsNitrile glove material was associated with reduced transmission of RBCs compared to single layer latex. Double layer latex gloves provided better protection than single layer latex or nitrile gloves.Conclusions These findings suggest that in protecting against blood transmission in the context of needlestick injuries, single layer nitrile gloves are superior to single layer latex gloves, but double gloving with latex gloves provides better protection than either single layer latex or nitrile.

Previous mental health conditions or psychological status at the beginning of employment did not appear to contribute significantly to call centre employees leaving within 6 months. Further similar studies in other occupational sectors are recommended.

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