title: Trends in condom use and risk behaviours after sexual exposure to HIV: a seven-year observational study.
abstract: OBJECTIVE
  We aimed to determine the trends in numbers and percentages of sexually exposed persons to HIV (SE) consulting an ED for post-exposure prophylaxis (PEP), as well as predictors of condom use.
  
  
  METHODS
  We conducted a prospective-observational study.
  
  
  METHODS
  We included all SE attendances in our Emergency Department (ED) during a seven-year study-period (2006-2012). Trends were analyzed using time-series analysis. Logistic Regression was used to define indicators of condom use.
  
  
  RESULTS
  We enrolled 1851 SE: 45.7% reported intercourse without condom-use and 12.2% with an HIV-infected partner. Significant (p<0.01) rising trends were observed in the overall number of SE visits (+75%), notably among men having sex with men (MSM) (+126%). There were rising trends in the number and percentage of those reporting intercourse without condom-use in the entire population +91% (p<0.001) and +1% (p>0.05), in MSM +228% (p<0.001) and +49% (p<0.001), in Heterosexuals +68% (p<0.001) and +10% (p = 0.08). Among MSM, significant rising trends were found in those reporting high-risk behaviours: anal receptive (+450% and +76%) and anal insertive (+l33% and +70%) intercourses. In a multivariate logistic regression analysis, heterosexuals, vaginal intercourse, visit during the night-shift and short time delay between SE and ED visit, were significantly associated with condom-use.
  
  
  CONCLUSIONS
  We report an increasing trend in the number of SE, mainly among MSM, and rising trends in high-risk behaviours and unprotected sexual intercourses among MSM. Our results indicate that SE should be considered as a high-risk population for HIV and sexually transmitted diseases.
authors.affiliation: Assistance Publique-Hôpitaux de Paris (AP-HP), University Hospital Bichat-Claude Bernard, Emergency Department, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, EA 7334 «Recherche clinique coordonnée ville-hôpital, Méthodologies et Société (REMES)», Paris, France; Study Group for Efficiency and Quality of Emergency Departments and Non-Scheduled Activities Departments, Paris, France; Hôpital Saint Camille, Bry-sur-Marne, France.
authors.forename: Enrique
authors.initials: E
authors.lastname: Casalino
authors.affiliation: Assistance Publique-Hôpitaux de Paris (AP-HP), University Hospital Bichat-Claude Bernard, Emergency Department, Paris, France; Study Group for Efficiency and Quality of Emergency Departments and Non-Scheduled Activities Departments, Paris, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Choquet
authors.affiliation: Assistance Publique-Hôpitaux de Paris (AP-HP), University Hospital Bichat-Claude Bernard, Emergency Department, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, EA 7334 «Recherche clinique coordonnée ville-hôpital, Méthodologies et Société (REMES)», Paris, France.
authors.forename: Agathe
authors.initials: A
authors.lastname: Leleu
authors.affiliation: Assistance Publique-Hôpitaux de Paris (AP-HP), University Hospital Bichat-Claude Bernard, Emergency Department, Paris, France; Study Group for Efficiency and Quality of Emergency Departments and Non-Scheduled Activities Departments, Paris, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Hellmann
authors.affiliation: Université Paris Diderot, Sorbonne Paris Cité, EA 7334 «Recherche clinique coordonnée ville-hôpital, Méthodologies et Société (REMES)», Paris, France; Study Group for Efficiency and Quality of Emergency Departments and Non-Scheduled Activities Departments, Paris, France; Hôpital Saint Camille, Bry-sur-Marne, France.
authors.forename: Mathias
authors.initials: M
authors.lastname: Wargon
authors.affiliation: Assistance Publique-Hôpitaux de Paris (AP-HP), University Hospital Bichat-Claude Bernard, Emergency Department, Paris, France; Study Group for Efficiency and Quality of Emergency Departments and Non-Scheduled Activities Departments, Paris, France.
authors.forename: Gaelle
authors.initials: G
authors.lastname: Juillien
authors.affiliation: Assistance Publique-Hôpitaux de Paris (AP-HP), University Hospital Bichat-Claude Bernard, Infectious and Tropical Diseases Department-AIDS Clinic, Paris, France.
authors.forename: Yazdan
authors.initials: Y
authors.lastname: Yazdanpanah
authors.affiliation: Assistance Publique-Hôpitaux de Paris (AP-HP), University Hospital Bichat-Claude Bernard, Infectious and Tropical Diseases Department-AIDS Clinic, Paris, France.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Bouvet
mesh_terms: D000328:Adult; D017280:Condoms; D005260:Female; D006678:HIV / Q000302:isolation & purification; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology*; D020010:Heterosexuality; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D012307:Risk Factors; D012309:Risk-Taking; D021841:Safe Sex; D012747:Sexual Partners; D055815:Young Adult