Evaluating counseling outcome on adherence to prophylaxis and follow-up after sexual HIV-risk exposure: a randomized controlled trial.
OBJECTIVE
Post-exposure prophylaxis (PEP) is recommended for the management of sexual HIV-risk exposure. However, a high percentage of exposed patients discontinue both their 28-day prophylaxis course before 15 days and HIV testing follow-up before M3. The objective of this study is to assess the efficacy of a counseling intervention in enhancing both adherence to PEP and HIV testing follow-up.


METHODS
Between 1 June 2004 and 31 December 2005, 54 patients exposed to sexual HIV-risk exposure were included in a multicenter, prospective, controlled, randomized trial, comparing a group receiving a counseling intervention in addition to traditional medical management (intervention group (IG), n=28) vs. a control group (CG, n=26). Patients in the IG received interactive counseling interventions focused on adherence to PEP and to HIV testing follow-up, led by specially trained nurses. The main outcome measures were proportion of patients achieving 100% adherence to PEP as evaluated on D15 by a self-completed patient questionnaire and on HIV testing on D45 and M3.


RESULTS
Groups were well balanced at baseline for age, sex, and circumstances of exposure. The proportion of 100% adherent patients to PEP was significantly higher in the IG compared to the CG (54% vs. 23%, p=0.036). Patients in the IG were more likely to complete the HIV testing follow-up at D45 (86% vs. 54%, p=0.023) and M3 (68% vs. 38%, p=0.056).


CONCLUSIONS
This study suggests the effectiveness of a counseling program to enhance adherence to both PEP and HIV testing follow-up after sexual exposure.
Bentz
L
L
Public Health Department, Nice University Hospital, BP, France. bentz.l@chu-nice.fr
Enel
P
P
Dunais
B
B
Durant
J
J
Poizot-Martin
I
I
Tourette-Turgis
C
C
Rebillon
M
M
Le Duff
F
F
Dellamonica
P
P
Pradier
C
C
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D003376:Counseling / Q000379:methods*; D005260:Female; D005602:France; D015658:HIV Infections / Q000188:drug therapy* / Q000517:prevention & control / Q000523:psychology; D006801:Humans; D008297:Male; D010349:Patient Compliance; D056990:Post-Exposure Prophylaxis / Q000379:methods*; D011446:Prospective Studies; D012307:Risk Factors; D012725:Sexual Behavior / Q000523:psychology*; D016896:Treatment Outcome
D019380:Anti-HIV Agents