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
First Published:
March
2008
Subjects:
AIDS & HIV;
AIDS & HIV Infection;
Allied Health;
Behavioral Medicine;
Child & Adolescent Psychiatry & Clinical Psychology;
Counseling;
Counselling - Social Work;
Ethics & Legal issues in Mental Health;
HIV & AIDS Counseling;
Health Psychology;
Infectious Diseases;
Medical Sociology;
Psychiatry & Clinical Psychology - Adult;
Public Health - Medical Sociology;
Risk;
Social Policy;
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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.
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| Keywords: Post-exposure Prophylaxis; HIV; prevention; non-occupational exposure; AIDS; feasibility |
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