Post-exposure prophylaxis in the era of pre-exposure prophylaxis.


Journal

HIV medicine
ISSN: 1468-1293
Titre abrégé: HIV Med
Pays: England
ID NLM: 100897392

Informations de publication

Date de publication:
11 2020
Historique:
accepted: 23 06 2020
pubmed: 10 9 2020
medline: 24 11 2021
entrez: 9 9 2020
Statut: ppublish

Résumé

56 Dean Street (56DS), a sexual health clinic in London, provides a quarter of England's HIV post-exposure prophylaxis following sexual exposure (PEPSE). Since the limited introduction of pre-exposure prophylaxis (PrEP) in 2015, PEPSE demand has fallen. We performed a case-note review of individuals who received PEPSE at 56DS in August 2018. Two hundred and forty three PEPSE were given; 97% (236) fitted recommended indications according to UK national guidance. Twenty-eight (12%) had documented prior PrEP use; the most common reason for not taking PrEP was lack of supply (15/28; 54%). Up to 1st April 2020, of 215 who had not previously used PrEP, 106 (49%) re-attended 56DS for PrEP initiation. At 56DS, PEPSE is appropriately given for high-risk HIV exposures. For those who use PrEP, It is important to support their adherence and ensure adequate supply. As PrEP uptake increases, the need for PEPSE may decrease.

Identifiants

pubmed: 32902098
doi: 10.1111/hiv.12917
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

668-670

Investigateurs

Keerti Gedela (K)
Sheena McCormack (S)
Diarmuid Nugent (D)
Sheel Patel (S)
Tara Suchak (T)
Victoria Tittle (V)

Informations de copyright

© 2020 British HIV Association.

Références

Cresswell F, Waters L, Briggs E et al. UK guideline for the use of HIV post-exposure prophylaxis following sexual exposure, 2015. Int J STD AIDS 2016; 27: 713-738.
UK Government GUMCAD STI surveillance system. Available at https://www.gov.uk/guidance/gumcad-sti-surveillance-system (accessed 15 June 2020).
Whitlock G, Nwokolo N, McOwan A. Is PEP prescribed appropriately? HIV Med 2015; 16: 519-520.
Whitlock G, Gibbons D, Longford N et al. Rapid testing and treatment for sexually transmitted infections improve patient care and yield public health benefits. Int J STD AIDS 2018; 29: 474-482.
Whitlock G, McCormack C, Fearnley J et al. High HIV incidence in men who have sex with men attending for postexposure prophylaxis: a service evaluation. Sex Transm Infect 2017; 93: 214-216.
Heuker J, Sonder G, Stolte I et al. High HIV incidence among MSM prescribed postexposure prophylaxis, 2000-2009: indications for ongoing sexual risk behaviour. AIDS 2012; 26: 505-512.
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Nwokolo N, Hill A, McOwan A, Pozniak A. Rapidly declining HIV infection in MSM in central London. Lancet HIV 2017; 4: e482-e483.
Scarfield P, Whitlock G. HIV diagnoses continue to fall at 56 Dean Street. EClinicalMedicine 2020; 19: 100263.
Whitlock G, Suchak T, Patel S et al. Declining PEP use: a consequence of PrEP? Poster 80, 4th Joint Conference of BHIVA with BASHH, HIV Med 19, 2018. Edinburgh.
Mahir G, El-Koubani O, Devitt E et al. High-risk MSM are switching from PEP to PrEP. Poster 16, HIV Glasgow conference 2018, Journal of the International AIDS Society, 21 (S8). 2018. Glasgow.
Gillespie L, Lowrie M, Metcalfe R. Has the introduction of HIV pre-exposure prophylaxis had an impact on HIV post-exposure prophylaxis for sexual exposure prescriptions in men who have sex with men in the UK's largest health board? Sex Transm Infect 2018; 94: 462.
Wood B. Prevention of HIV for persons with low-frequency, high-risk expsoures: PrEP (preexposure prophylaxis), PEP (postexposure prophylaxis), or ‘PIP’ (postexposure prophylaxis in-pocket). AIDS 2020; 34: 481-482.
UK Government. Available at https://www.gov.uk/government/news/hiv-drug-prep-to-be-available-across-england (accessed 20 May 2020).

Auteurs

M Atim (M)

Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.

N Girometti (N)

Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.

I Hyndman (I)

Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.

A McOwan (A)

Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.

G Whitlock (G)

Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.

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