Prescribing practices in a population-based HIV postexposure prophylaxis program.
OBJECTIVE
To characterize factors associated with being prescribed triple or double postexposure prophylaxis (PEP) against HIV in a population-based program.


METHODS
Individuals potentially exposed to HIV received a 5 day starter kit of either double or triple antiretroviral PEP between April 1999 and November 2000 and did/did not receive the remaining 23 days PEP. Data were collected through dispensation of kits. Logistic regression identified characteristics independently associated with being prescribed triple therapy starter kits and with any 23 day follow-up.


RESULTS
Of 2064 people receiving 5 day PEP [403 (20%) triple and 1661 (80%) double], 590 (29%) received 23 day follow-up. Independently associated with being prescribed triple therapy starter kits were being male [adjusted odds ratio (AOR) 1.38; 95% confidence interval (CI) 1.10-1.74; P = 0.006), occupational mucocutaneous injuries (AOR 1.70; 95% CI, 1.14-2.55; P = 0.010), and community needlesticks (AOR 2.04; 95% CI, 1.54-2.69; P < 0.001). Independently associated with being prescribed the 23 day follow-up were being male (AOR 1.24; 95% CI, 1.00-1.53; P = 0.04), community mucocutaneous incidents (AOR 2.83; 95% CI, 1.41-5.70; P = 0.004), community needlesticks (AOR 1.75; 95% CI, 1.33-2.29; P < 0.001), and having received triple therapy as the starter kit (AOR 2.61; 95% CI, 2.07-3.29; P < 0.001).


CONCLUSIONS
Being prescribed triple therapy starter PEP was associated with being male and with experiencing an occupational mucocutaneous or community needlestick injury. Receiving the remaining 23 days PEP was associated with being male, experiencing a community mucocutaneous or needlestick injury, and triple therapy as the initial 5 day starter PEP.
Braitstein
Paula
P
Division of Epidemiology and Population Health, BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, British Columbia V6Z 1Y6, Canada.
Chan
Keith
K
Beardsell
Ann
A
McLeod
Alistair
A
Montaner
Julio S G
JS
O'Shaughnessy
Michael V
MV
Hogg
Robert S
RS
D000059:Accidents; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D001734:Bites, Human; D001955:British Columbia; D017714:Community-Acquired Infections / Q000635:transmission*; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D017320:HIV Protease Inhibitors / Q000627:therapeutic use; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use; D008297:Male; D009092:Mucous Membrane / Q000293:injuries; D016602:Needlestick Injuries; D019888:Nelfinavir / Q000627:therapeutic use; D016273:Occupational Exposure; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011902:Rape; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use; D012306:Risk; D012867:Skin / Q000293:injuries; D018119:Stavudine / Q000627:therapeutic use
D019380:Anti-HIV Agents; D017320:HIV Protease Inhibitors; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine; D018119:Stavudine; D019888:Nelfinavir