title: Feasibility of postexposure prophylaxis (PEP) against human immunodeficiency virus infection after sexual or injection drug use exposure: the San Francisco PEP Study.
abstract: The feasibility of providing postexposure prophylaxis (PEP) after sexual or injection drug use exposures to human immunodeficiency virus (HIV) was evaluated. PEP was provided within 72 h to individuals with exposures from partners known to have or to be at risk for HIV infection. PEP consisted of 4 weeks of antiretroviral medications and individually tailored risk-reduction and medication-adherence counseling. Among 401 participants seeking PEP, sexual exposures were most common (94%; n=375). Among sexual exposures, receptive (40%) and insertive (27%) anal intercourse were the most common sexual acts. The median time from exposure to treatment was 33 h. Ninety-seven percent of participants were treated exclusively with dual reverse-transcriptase inhibitors, and 78% completed the 4-week treatment. Six months after the exposure, no participant developed HIV antibodies, although a second PEP course for a subsequent exposure was provided to 12%. PEP, after nonoccupational HIV exposure, is feasible for persons at risk for HIV infection.
authors.affiliation: Positive Health Program, Dept. of Medicine, University of California-San Francisco, at San Francisco General Hospital, 995 Potrero Ave., San Francisco, CA 94110, USA. jkahn@php.ucsf.edu
authors.forename: J O
authors.initials: JO
authors.lastname: Kahn
authors.forename: J N
authors.initials: JN
authors.lastname: Martin
authors.forename: M E
authors.initials: ME
authors.lastname: Roland
authors.forename: J D
authors.initials: JD
authors.lastname: Bamberger
authors.forename: M
authors.initials: M
authors.lastname: Chesney
authors.forename: D
authors.initials: D
authors.lastname: Chambers
authors.forename: K
authors.initials: K
authors.lastname: Franses
authors.forename: T J
authors.initials: TJ
authors.lastname: Coates
authors.forename: M H
authors.initials: MH
authors.lastname: Katz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D016358:Contact Tracing; D003376:Counseling; D016049:Didanosine / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000517:prevention & control*; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D019888:Nelfinavir / Q000627:therapeutic use; D010349:Patient Compliance; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*; D012307:Risk Factors; D012309:Risk-Taking; D015229:Sexually Transmitted Diseases, Viral / Q000188:drug therapy / Q000517:prevention & control*; D015819:Substance Abuse, Intravenous / Q000150:complications*; D013997:Time Factors; D015215:Zidovudine / Q000627:therapeutic use
chemical_list: D019380:Anti-HIV Agents; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine; D015215:Zidovudine; D019888:Nelfinavir; D016049:Didanosine