Post-exposure prophylaxis following sexual exposure to HIV: a seven-year retrospective analysis in a regional centre

McCarty, E J; Quah, SP; Maw, R D; Dinsmore, W W; Emerson, C R

doi:10.1258/ijsa.2009.009463

Cited by 17 publications

(18 citation statements)

References 13 publications

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“…In surveys conducted among attendees at the Seattle Gay Pride parade (2009–2012) only 26% of attendees were aware of nPEP [unpublished data, Elizabeth Barash]. The majority of studies, with a few exceptions [6], [28], report low demand for nPEP [13], [29]–[31]. In order to access and benefit from nPEP, individuals must overcome many barriers: 1) recognize an exposure to HIV; 2) be aware of nPEP and where to obtain it; 3) report for care within 72 hours of exposure; 4) have the means to pay for nPEP if they are un- or under-insured and cannot access assistance programs; and 5) preferably know or determine the HIV status of her/his contact.…”

Section: Discussionmentioning

confidence: 99%

Non-Occupational Post-Exposure Prophylaxis for HIV: 10-Year Retrospective Analysis in Seattle, Washington

et al. 2014

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Despite treatment guidelines in place since 2005, non-occupational post-exposure HIV prophylaxis (nPEP) remains an underutilized prevention strategy. We conducted a retrospective chart review of patients presenting to a publicly-funded HIV clinic in Seattle, Washington for nPEP between 2000 and 2010 (N = 360). nPEP prescriptions were provided for 324 (90%) patients; 83% of prescription decisions were appropriate according to Centers for Disease Control and Prevention guidelines, but only 31% (N = 111/360) of patients were considered “high risk.” In order to use limited resources most efficiently, public health agencies should target messaging for this high-cost intervention to individuals with high-risk HIV exposures.

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Section: Discussionmentioning

confidence: 99%

Non-Occupational Post-Exposure Prophylaxis for HIV: 10-Year Retrospective Analysis in Seattle, Washington

et al. 2014

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“…This compares favourably with the Victorian nPEP program which reported that 34% of nPEP clients had been tested at three month follow-up [13]. Hospitals in the UK [14] and France [15] have also reported low follow-up testing of nPEP clients after three months (35% and 29% respectively). Studies examining testing rates over time further highlight the challenge of improving post-nPEP testing.…”

Section: Discussionmentioning

confidence: 68%

Improved awareness and appropriate use of non-occupational post-exposure prophylaxis (nPEP) for HIV prevention following a multi-modal communication strategy

et al. 2012

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BackgroundIn May 2005, the Western Australian Department of Health (WA Health) developed a communication strategy to improve the awareness and appropriate use of non-occupational post-exposure prophylaxis (nPEP) in WA. The communication strategy included the development of an nPEP information pamphlet, the establishment of a 24 hour nPEP phone line and the distribution of the WA Health nPEP guidelines to health professionals. The communication strategy was aimed at gay men, people in sero-discordant relationships, people living with HIV, injecting drug users and health care providers with patients from these populations. This evaluation aimed to assess the awareness and appropriate use of nPEP in WA before and after the commencement of the nPEP communication strategy.MethodsA program logic method was used to identify the immediate (short-term) and ultimate (long-term) outcomes of the communication strategy. The achievement of these outcomes was evaluated using data from website statistics, a survey of ‘sexuality sensitive’ doctors, statistics published in Perth Gay Community Periodic Surveys (PGCPS) and data from the WA nPEP database. A χ2 test for trend was conducted to identify any significant changes in the ultimate outcome indicators pre- and post-strategy.ResultsnPEP awareness among gay men in the PGCPS initially increased from 17.2% in 2002 to 54.9% in 2008, then decreased to 39.9% in 2010. After the commencement of the communication strategy, the proportion of nPEP prescriptions meeting the eligibility criteria for nPEP significantly increased (61.2% in 2002-2005 to 90.0% in 2008-2010 (p < .001)). The proportion of nPEP recipients who completed the prescribed course of nPEP (46.6% in 2002-2005 to 66.9% in 2008-2010 (p = .003)) and the proportion who received a post-nPEP HIV test three to four months after the first visit for nPEP (38.8% in 2002-2005 to 51.9% in 2008-2010 (p = .023)) also increased.ConclusionsSince the introduction of the nPEP communication strategy, the delivery and appropriate use of nPEP have significantly improved in WA. In the 2008-2010 period, an improvement in HIV testing of nPEP recipients at three month follow-up was reported for the first time in WA. However, there is a need for ongoing activities to raise nPEP awareness among gay men.

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“…Of these women who received nPEP, only 41% returned for follow-up at 2, 4, 12, and 24 weeks, of which 60% reported taking at least 21 days of the prescribed course of therapy [23]. Other retrospective studies involving nPEP following high-risk exposures including SA from other countries have reported similar completion rates between 60% and 64% [24,25].…”

Section: Key Questionmentioning

confidence: 96%

Sexual Assault and Sexually Transmitted Infections in Adults, Adolescents, and Children

et al. 2015

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Survivors of sexual assault are at risk for acquiring sexually transmitted infections (STIs). We conducted literature reviews and invited experts to assist in updating the sexual assault section for the 2015 Centers for Disease Control and Prevention sexually transmitted diseases (STD) treatment guidelines. New recommendations for STI management among adult and adolescent sexual assault survivors include use of nucleic acid amplification tests (NAATs) for detection of Trichomonas vaginalis by vaginal swabs; NAATs for detection of Neisseria gonorrhoeae and Chlamydia trachomatis from pharyngeal and rectal specimens among patients with a history of exposure or suspected extragenital contact after sexual assault; empiric therapy for gonorrhea, chlamydia, and trichomoniasis based on updated treatment regimens; vaccinations for human papillomavirus (HPV) among previously unvaccinated patients aged 9-26 years; and consideration for human immunodeficiency virus (HIV) nonoccupational postexposure prophylaxis using an algorithm to assess the timing and characteristics of the exposure. For child sexual assault (CSA) survivors, recommendations include targeted diagnostic testing with increased use of NAATs when appropriate; routine follow-up visits within 6 months after the last known sexual abuse; and use of HPV vaccination in accordance with national immunization guidelines as a preventive measure in the post-sexual assault care setting. For CSA patients, NAATs are considered to be acceptable for identification of gonococcal and chlamydial infections from urine samples, but are not recommended for extragenital testing due to the potential detection of nongonococcal Neisseria species. Several research questions were identified regarding the prevalence, detection, and management of STI/HIV infections among adult, adolescent, and pediatric sexual assault survivors.

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Post-exposure prophylaxis following sexual exposure to HIV: a seven-year retrospective analysis in a regional centre

Cited by 17 publications

References 13 publications

Non-Occupational Post-Exposure Prophylaxis for HIV: 10-Year Retrospective Analysis in Seattle, Washington

Non-Occupational Post-Exposure Prophylaxis for HIV: 10-Year Retrospective Analysis in Seattle, Washington

Improved awareness and appropriate use of non-occupational post-exposure prophylaxis (nPEP) for HIV prevention following a multi-modal communication strategy

Sexual Assault and Sexually Transmitted Infections in Adults, Adolescents, and Children

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