PEP after condom failure — CCE clinical encounter

CCE-style clinical encounter: a 30-year-old presenting 40 hours after condom failure with a partner of unknown HIV status, anxious and googling. The candidate must deliver PEP inside the clock, screen for co-infections, set the monitoring calendar, and open the PrEP conversation for the future.

clinical encounter with role-player (CCE format)2 min readVerification in progress

Prompt

A 30-year-old hospitality worker attends urgently on a Sunday: a condom broke last night (about 40 hours ago) during intercourse with a new partner whose HIV status he does not know. He has read online that 'you have three days'. He is tearful, apologising repeatedly. No previous HIV tests; no regular GP; drinks heavily on weekends; also reports a urethral sting this morning.

Objectives

Take an exposure history fast enough to protect the PEP clock while staying warm. ^[7]
Deliver first-dose PEP now with correct regimen framing and duration. ^[7]
Screen and manage the concurrent STI symptom. ^[7]
Set the follow-up calendar: baseline serology done, completion testing booked. ^[7]
Open the PrEP conversation for ongoing risk without overloading today. ^[1]

References4Show

[1]McCormack S, Dunn DT, Desai M, Dolling DI, Gafos M, et al. Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial. Lancet, 2016.PMID 26364263
[2]Molina JM, Capitant C, Spire B, Pialoux G, Cotte L, et al. On-Demand Preexposure Prophylaxis in Men at High Risk for HIV-1 Infection. N Engl J Med, 2015.PMID 26624850
[7]Tanner MR, O'Shea JG, Byrd KM, Johnston M, Dumitru GG, et al. Antiretroviral Postexposure Prophylaxis After Sexual, Injection Drug Use, or Other Nonoccupational Exposure to HIV - CDC Recommendations, United States, 2025. MMWR Recomm Rep, 2025.PMID 40331832
[9]Chu C, Selwyn PA Diagnosis and initial management of acute HIV infection. Am Fam Physician, 2010.PMID 20507048

PEP after condom failure — CCE clinical encounter

clinical encounter with role-player (CCE format)2 min readVerification in progress

Objectives

Take an exposure history fast enough to protect the PEP clock while staying warm. ^[7]

Deliver first-dose PEP now with correct regimen framing and duration. ^[7]

Screen and manage the concurrent STI symptom. ^[7]

Set the follow-up calendar: baseline serology done, completion testing booked. ^[7]

Open the PrEP conversation for ongoing risk without overloading today. ^[1]

References4Show

[1]McCormack S, Dunn DT, Desai M, Dolling DI, Gafos M, et al. Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial. Lancet, 2016.PMID 26364263
[2]Molina JM, Capitant C, Spire B, Pialoux G, Cotte L, et al. On-Demand Preexposure Prophylaxis in Men at High Risk for HIV-1 Infection. N Engl J Med, 2015.PMID 26624850
[7]Tanner MR, O'Shea JG, Byrd KM, Johnston M, Dumitru GG, et al. Antiretroviral Postexposure Prophylaxis After Sexual, Injection Drug Use, or Other Nonoccupational Exposure to HIV - CDC Recommendations, United States, 2025. MMWR Recomm Rep, 2025.PMID 40331832
[9]Chu C, Selwyn PA Diagnosis and initial management of acute HIV infection. Am Fam Physician, 2010.PMID 20507048