If you've had a potential HIV exposure, go immediately to the Pronto Soccorso (emergency room) of a hospital with a Malattie Infettive (Infectious Diseases) unit. The Italian system handles PEP well — it's free or low-cost with EHIC, and the process is clear.

The 72-Hour Rule

PEP (Profilassi Post-Esposizione / PPE) must start within 72 hours of exposure. The sooner the better — within 24 hours is significantly more effective. Do not wait to see if symptoms develop. Go now.

What to Say

At triage, say: "Ho avuto un rapporto a rischio HIV. Ho bisogno della PPE — Profilassi Post-Esposizione." (I had an HIV-risk exposure. I need PEP — post-exposure prophylaxis.)

You'll likely be given a yellow or green triage code (not immediately life-threatening) and wait for the infectious disease team. This is normal — stay and wait.

Where to Go: Major Cities

Milan:

  • Ospedale Luigi Sacco (Via G.B. Grassi 74) — primary infectious disease centre, best first choice
  • Ospedale Niguarda (Piazza dell'Ospedale Maggiore 3) — good 24h Pronto Soccorso
  • Ospedale San Raffaele (Via Olgettina 60) — private hospital but accepts EHIC

Rome:

  • IRCCS Istituto Nazionale Malattie Infettive Lazzaro Spallanzani (Via Portuense 292) — the national reference centre for infectious diseases. Best choice in Rome for PEP, PrEP, and HIV-related care.
  • Policlinico Umberto I (Viale del Policlinico 155) — large general hospital with Malattie Infettive unit

Bologna:

  • Policlinico Sant'Orsola-Malpighi (Via Albertoni 15) — main hospital, Malattie Infettive unit, connected to BLQ Checkpoint's fast-track network

Florence:

  • Ospedale Santa Maria Nuova or Ospedale Careggi — ask for Malattie Infettive at Pronto Soccorso

Naples:

  • Ospedale Cotugno (Via Quagliariello 54) — specifically an infectious disease hospital, primary choice for Naples

Turin:

  • Ospedale Amedeo di Savoia (Corso Svizzera 164) — Turin's dedicated infectious disease hospital

The Process

  1. Triage: State your need for PPE (PEP) clearly
  2. Wait: You'll be seen by an infettivologo (infectious disease specialist)
  3. Risk assessment: The doctor will assess exposure type and risk level
  4. PEP starter pack: If indicated, the medication is dispensed from the hospital pharmacy (farmacia ospedaliera)
  5. Follow-up: You'll be given a prescription for the full 28-day course and a monitoring appointment

Cost

EU citizens with EHIC (TEAM card): Emergency care including PEP is free or at the Italian ticket rate. Non-EU visitors: Emergency care is provided regardless of ability to pay. You may be billed afterward — travel insurance should cover this. Italian SSN residents: Free under emergency care provisions.

What PEP Is and Isn't

PEP is a 28-day course of antiretroviral medication that prevents HIV infection after a specific exposure. It must be taken consistently every day for the full 28 days. It is not a substitute for ongoing PrEP. After completing PEP, get an HIV test at 6 weeks and again at 3 months.

See the PEP Emergency general guide for full detail.

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