title: Evaluating counseling outcome on adherence to prophylaxis and follow-up after sexual HIV-risk exposure: a randomized controlled trial.
abstract: 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.
authors.affiliation: Public Health Department, Nice University Hospital, BP, France. bentz.l@chu-nice.fr
authors.forename: L
authors.initials: L
authors.lastname: Bentz
authors.forename: P
authors.initials: P
authors.lastname: Enel
authors.forename: B
authors.initials: B
authors.lastname: Dunais
authors.forename: J
authors.initials: J
authors.lastname: Durant
authors.forename: I
authors.initials: I
authors.lastname: Poizot-Martin
authors.forename: C
authors.initials: C
authors.lastname: Tourette-Turgis
authors.forename: M
authors.initials: M
authors.lastname: Rebillon
authors.forename: F
authors.initials: F
authors.lastname: Le Duff
authors.forename: P
authors.initials: P
authors.lastname: Dellamonica
authors.forename: C
authors.initials: C
authors.lastname: Pradier
mesh_terms: 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
chemical_list: D019380:Anti-HIV Agents