title: Non-occupational post-exposure prophylaxis in Victoria, Australia: responding to high rates of re-presentation and low rates of follow-up.
abstract: In Australia, the non-occupational post-exposure prophylaxis service in Victoria (VNPEPS) maintains a database of non-occupational post-exposure prophylaxis (NPEP) use throughout the state. Through the database the service can monitor and respond to patterns of NPEP presentation, re-presentation and follow-up as well as those who test positive for HIV. We describe a cohort of NPEP individuals from the commencement of the service to 31 December 2009. During this time, 1864 individuals presented for NPEP on 2396 occasions. The majority (85%) were men who have sex with men (MSM) presenting after receptive anal intercourse (56.1%). Repeat NPEP presentations were high (17.5%) and follow-up testing at week 12 post-NPEP was low (34%). Twenty-two patients (1.2%) tested positive for HIV at baseline presentation and six patients seroconverted to HIV during follow-up. The VNPEPS has initiated strategies to encourage behaviour change for those who re-present for NPEP, and to improve rates of week 12 follow-up.
authors.affiliation: Infectious Diseases Unit, Victorian NPEP Service, The Alfred Hospital, Victoria, Australia. j.armishaw@alfred.org.au
authors.forename: J
authors.initials: J
authors.lastname: Armishaw
authors.forename: J F
authors.initials: JF
authors.lastname: Hoy
authors.forename: K M
authors.initials: KM
authors.lastname: Watson
authors.forename: E J
authors.initials: EJ
authors.lastname: Wright
authors.forename: B G
authors.initials: BG
authors.lastname: Price
authors.forename: A B
authors.initials: AB
authors.lastname: Pierce
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019380:Anti-HIV Agents / Q000627:therapeutic use; D001315:Australia / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*; D006679:HIV Seropositivity; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D056990:Post-Exposure Prophylaxis / Q000706:statistics & numerical data*; D012725:Sexual Behavior / Q000706:statistics & numerical data*
chemical_list: D019380:Anti-HIV Agents