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Non-occupational post exposure prophylaxis as a biobehavioral HIV-prevention intervention 

Authors: S. Shoptaw abc;  E. Rotheram-Fuller a;  R. J. Landovitz d;  J. Wang a;  A. Moe d;  D. E. Kanouse e; C. Reback c
Affiliations:   a UCLA Department of Family Medicine, Los Angeles, US
b UCLA Department of Psychiatry and Biobehavioral Sciences, Los Angeles, US
c Friends Research Institute, Inc., Los Angeles, US
d UCLA Center for Clinical AIDS Research and Education (CARE), Los Angeles, US
e RAND Corporation, Santa Monica, CA, US
DOI: 10.1080/09540120701660353
Publication Frequency: 12 issues per year
Published in: journal AIDS Care, Volume 20, Issue 3 March 2008 , pages 376 - 381
First Published: March 2008
Formats available: HTML (English) : PDF (English)
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Abstract

This project evaluated the feasibility and safety of a community-planned and financed program of non-occupational post exposure prophylaxis (nPEP) for 100 individuals. Individuals seeking nPEP within 72 hours of a potential HIV exposure were provided 28-day treatment using twice-daily lamivudine and zidovudine. Participants received a physical examination, HIV test and medications and were scheduled for follow-up counseling and data visits to 26-weeks. Results showed participants were highly educated (mean = 14.7 years), gay identified (63%), males (95%) who experienced an atypical, high-risk sexual event. Two participants tested HIV-positive at intake, who were previously unaware of their HIV status. The strongest demand (31% of cases) was on Mondays. The index event for the majority of cases (58%) involved unprotected anal sex, with 18% reporting condom failures. Only 15% tested positive for illicit drugs at initial visit. Of those dispensed the full 28 days of medication (n=84), 63 successfully completed the treatment course (75%). Retention dropped rapidly after the initial study visit, with only 49% completing a 26-week follow-up visit. No incident seroconversions were observed. That 75% of participants completed a full course of nPEP adds to the emerging evidence regarding nPEP feasibility. This project demonstrates the need for further research in the implementation of nPEP as a biobehavioral strategy for high-risk groups within a comprehensive HIV-prevention plan.
Keywords: Post-exposure Prophylaxis; HIV; prevention; non-occupational exposure; AIDS; feasibility
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