Provincial guidelines for HIV non-occupational postexposure prophylaxis (NPEP) were implemented on January 2005 in Alberta, Canada. Human immunodeficiency virus (HIV) NPEP was provided free of charge following approval by a medical officer of health. Between 1 January 2005 and 30 June 2007, 174 individuals were prescribed NPEP; 135 (78%) were women with a median age of 24 years. Sexual assaults accounted for 68% of exposures. NPEP was completed in 49% of cases. Individuals who completed NPEP were less likely to have been exposed by sexual assault (P = 0.04) and more likely to have received HIV follow-up testing (P = 0.03).Individuals who received at least one HIV follow-up test were older (P = 0.03) and more likely to have been exposed percutaneously (P = 0.003). Those who received no follow-up testing were less likely to have filled an NPEP prescription (P = 0.0001). New strategies are required to improve follow-up of individuals receiving NPEP, especially younger persons or sexual assault survivors.