title: Nonoccupational post-exposure prophylaxis for HIV in New York State Emergency Departments.
abstract: New York State (NYS) established guidelines for nonoccupational post-exposure prophylaxis (nPEP) to HIV in 1997. To assess current nPEP practices in NYS Emergency Departments (EDs), we electronically surveyed all ED directors in NYS, excluding Veterans' Affairs hospitals, about nPEP and linkage-to-care protocols in the EDs. Basic descriptive statistics were used for analysis. The response rate was 96% (184/191). Of respondents, 88% reported evaluating any patient with a possible nonoccupational exposure to HIV, in accordance with NYS guidelines. Of these, 83% provided the patient with a starter pack of medications, while 4% neither supplied nor prescribed antiretroviral drugs in the ED. Sexually transmitted infection screening, risk reduction counseling, and education about symptoms of acute HIV seroconversion were performed inconsistently, despite NYS guidelines recommendations. Only 22% of EDs confirmed whether linkage to follow-up care was successful. Most NYS EDs prescribe nPEP to appropriate patients but full implementation of guidelines remains incomplete.
authors.affiliation: Weill Cornell Medical College, New York, NY, USA.
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Fitzpatrick
authors.affiliation: Department of Emergency Medicine, New York University School of Medicine, New York, NY, USA daniel.egan@nyumc.org.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Egan
authors.affiliation: Department of Emergency Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Ethan
authors.initials: E
authors.lastname: Cowan
authors.affiliation: New York State Department of Health, AIDS Institute, New York, NY, USA.
authors.forename: Leah M
authors.initials: LM
authors.lastname: Savitsky
authors.affiliation: New York State Department of Health, AIDS Institute, New York, NY, USA.
authors.forename: John D
authors.initials: JD
authors.lastname: Kushner
authors.affiliation: Department of Emergency Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Yvette
authors.initials: Y
authors.lastname: Calderon
authors.affiliation: New York State Department of Health, AIDS Institute, New York, NY, USA.
authors.forename: Bruce D
authors.initials: BD
authors.lastname: Agins
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use; D037001:Directive Counseling; D004636:Emergency Service, Hospital; D019983:Guideline Adherence; D015658:HIV Infections / Q000175:diagnosis* / Q000517:prevention & control*; D019538:Health Care Surveys; D006801:Humans; D008403:Mass Screening; D009518:New York; D010353:Patient Education as Topic; D056990:Post-Exposure Prophylaxis; D017410:Practice Guidelines as Topic; D040242:Risk Reduction Behavior
chemical_list: D019380:Anti-HIV Agents
keywords: HIV; emergency department; post-exposure prophylaxis; prevention