A 28-year-old male physician assistant accidentally sticks himself in the hand with a needle after drawing blood from a patient with HIV. The nurse had taken nonoccupational postexposure prophylaxis for a sexual exposure about 1 year ago with bictegravir-tenofovir alafenamide-emtricitabine, but did not tolerate the regimen well. For this reason, the decision was made to initiate HIV occupational postexposure prophylaxis (PEP) with an alternative regimen that does not include an Integrase strand transfer inhibitor.