References UK clinical guidance from the NHS, the British HIV Association (BHIVA), and the British Association for Sexual Health and HIV (BASHH). Last updated: April 2026.
Needlestick injuries — accidental skin pricks from a used needle — carry a small but real risk of HIV transmission. The risk is highest for healthcare workers, though it can also affect cleaners, emergency responders and members of the public who find discarded needles. With prompt first aid and PEP (post-exposure prophylaxis) when appropriate, HIV can almost always be prevented.
Here’s what to do.
Order a discreet home HIV test
What Is the Risk?
The average risk of HIV transmission from a single needlestick injury with an HIV-positive source is about 0.23% — roughly 1 in 440 exposures. The risk depends on:
| Factor | Higher Risk | Lower Risk |
|---|---|---|
| Depth of injury | Deep puncture | Superficial scratch |
| Visible blood | Yes | No |
| Hollow-bore needle | Yes | Solid needle |
| Source viral load | High/detectable | Undetectable |
| Time since source used it | Recent | Older/dried |
Immediate First Aid
- Encourage bleeding by gently pressing around the wound — don’t squeeze tightly
- Wash thoroughly with soap and running water
- Don’t scrub or use antiseptic that damages the skin further
- Cover with a waterproof dressing
- Report the injury immediately — to your occupational health team, sexual health clinic or A&E
Medical Assessment
Urgent assessment is needed to decide whether PEP is indicated. The healthcare professional will ask about:
- When and how the injury happened
- Whether the source is known
- The source’s HIV status (if known)
- The depth and type of injury
PEP (Post-Exposure Prophylaxis)
PEP is a 28-day course of antiretroviral medication that can prevent HIV if started within 72 hours of exposure (the sooner the better). For needlestick injuries, PEP is usually recommended if:
- The source is known to be HIV-positive with a detectable viral load
- The source’s status is unknown but risk factors are present
- The injury was significant (deep puncture, visible blood, hollow needle)
PEP is not usually needed if the source is known to be HIV-negative or is HIV-positive with a sustained undetectable viral load.
Follow-Up Testing
- HIV test at baseline (before or at the time of injury)
- Repeat at 4-6 weeks after exposure
- Final test at 3 months to confirm
- Hepatitis B and C testing also recommended
Other Infections to Consider
Needlestick injuries can also transmit hepatitis B and C:
- Hepatitis B — if unvaccinated, you may need booster vaccine or immunoglobulin
- Hepatitis C — no prophylaxis exists, but early detection and treatment are curative
Read more: PrEP and PEP | Hepatitis B and HIV | What is HIV?
Frequently Asked Questions
How long do I have to start PEP after a needlestick?
Ideally within a few hours. The absolute deadline is 72 hours, but sooner is much better. Contact a sexual health clinic or A&E immediately.
Is HIV risk high from discarded street needles?
The risk is very low. HIV doesn’t survive well outside the body, and needles found in the street have usually been unused for some time. PEP may still be considered depending on circumstances.
Do I need PEP if the source is undetectable?
Usually no. If the source is on effective HIV treatment with a sustained undetectable viral load, transmission from a needlestick is considered extremely unlikely.
Related reading
- Can Condoms Protect Against HIV?
- Can You Catch an STI From a Toilet Seat?
- Can You Get Chlamydia From Kissing?
- Can You Get Herpes From a Toilet Seat?
- Can You Get Herpes From Kissing?
Sources
- NHS — Sexual health conditions
- BASHH — UK clinical guidelines for STI management
- British HIV Association (BHIVA) — HIV treatment guidelines
- Terrence Higgins Trust — sexual health information
- UK Health Security Agency — STI surveillance data
Steve Page is a recognised expert on Sexually Transmitted Diseases (STDs) and STD treatments, having published numerous articles in peer-reviewed journals and presented his research at conferences around the world. He has an in-depth understanding of the latest medical research on STDs, and is an advocate for the development of new treatments and protocols to improve the health of those affected. In addition to his research, he has dedicated his career to understanding the causes and symptoms of STDs, as well as how to best treat those impacted.
