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Background and Importance PEP is a key strategy to prevent HIV infection after accidental exposure. Unlike pre-exposure prophylaxis (PrEP), which is indicated for individuals at ongoing risk, PEP is prescribed for those exposed to a single high-risk event. Although its effectiveness is well documented, real-world evidence on adherence, safety, and identifying candidates for transitioning to PrEP remains limitedAim and Objectives To evaluate the effectiveness and safety of PEP in individuals treated during 2023. Secondary objectives were to analyse prescribing patterns, patient characteristics, reasons for initiating PEP, and the proportion of patients who were eligible for PrEP after completing PEP.Material and Methods A retrospective, observational study was conducted including all individuals who initiated PEP between January and December 2023. Data collected from electronic medical records included demographics, psychiatric history, reason for exposure, baseline and follow-up renal and hepatic function, HIV serology, sexually transmitted infections (STIs), adverse drug reactions (ADRs), and completion of treatment.Results Seventy-six patients received PEP. Most were men (67.1%), with a median age of 32 years (IQR 22–45.5). The main reasons for initiation were unprotected sex (42.1%), biological accidents (26.3%), sexual assault (17.1%), and condom failure (14.5%). The most frequent regimen was tenofovir disoproxil fumarate/emtricitabine plus raltegravir (94.7%). Alternative regimens were prescribed in cases of renal impairment, lactose intolerance, or intolerance to the standard regimen. PEP was initiated within 24 hours in 71.1% of cases. Completion rate was 97.4%, with 100% negative HIV serology at 4 and 12 weeks. A transient increase in ALT was observed at week 4 (p=0.004), which normalised by week 12. No significant changes in creatinine were detected. Four patients (5.2%) were diagnosed with STIs during follow-up. Fifteen patients (19.7%) were referred for PrEP after completing PEP.Conclusion and Relevance PEP is well-tolerated and highly adhered to when initiated promptly. Standard regimens are effective and require minimal adjustment. Monitoring for liver function is advisable due to transient ALT changes. Follow-up care is essential for STI detection and to identify candidates for ongoing prevention strategies like PrEP. These findings support the importance of timely intervention and comprehensive post-exposure management.Conflict of Interest No conflict of interest