Feasibility of postexposure prophylaxis (PEP) against human immunodeficiency virus infection after sexual or injection drug use exposure: the San Francisco PEP Study.
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.
Kahn
J O
JO
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
Martin
J N
JN
Roland
M E
ME
Bamberger
J D
JD
Chesney
M
M
Chambers
D
D
Franses
K
K
Coates
T J
TJ
Katz
M H
MH
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
D019380:Anti-HIV Agents; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine; D015215:Zidovudine; D019888:Nelfinavir; D016049:Didanosine