title: Predictors of Standard Follow-Up Completion after Sexual Exposure to HIV: Five-Year Retrospective Analysis in a French HIV-Infection Care Center.
abstract: OBJECTIVE
  The care of exposed individuals to HIV remains a challenge regarding follow-up completion and HIV-testing of the partner. Identifying patients with risk of not fulfilling HIV-testing follow-up completion (FC), among patients demanding non-occupational post-exposure prophylaxis (nPEP), may improve clinical practice.
  
  
  METHODS
  A retrospective chart review was conducted in a single French HIV-infection care center. FC predictors were assessed in a multivariate logistic regression model (Likelihood ratios test).
  
  
  RESULTS
  Between 2009 and 2013, 646 sexual exposures to HIV were evaluated for nPEP, of which 507 effectively received nPEP (78%). FC rate was 30% (194/646). In the multivariate analysis, FC rates rose with age of exposed individuals (OR, 1.04 [0.25-4.28]; p<0.001) and decreased with the year of sexual exposure (OR, 0.74 [0.65-0.85]; p<0.001). FC was associated with sexual encounter with a sex worker (OR, 4.07 [0.98-16.82]; p<0.001) and nPEP use (OR, 2.69 [2.37-3.06]; p<0.001). nPEP early discontinuation was associated with decreased FC rates (OR, 0.18 [0.08-0.39]; p<0.001). No documented nPEP failure was identified. However, five Men who have Sex with Men (MSM) nPEP recipients for unprotected anal receptive intercourse subsequently seroconverted to HIV more than 6 months after nPEP. Seroconversion to HIV was associated with the lack of FC (p = 0.04) and multiple presentations for nPEP over the study period (p = 0.002).
  
  
  CONCLUSIONS
  We identified significant predictors of not fulfilling sequential HIV-testing. They appear to be linked with a self-perceived HIV risk, especially in young adults recently exposed. Enhanced counseling in targeted individuals with high risk behaviors and using smartphone and internet-based strategies may be interesting retention in care options.
authors.affiliation: Le Trait d'Union, HIV-infection care center, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Gantner
authors.affiliation: Biostatistics Laboratory, Faculté de Médecine, Université de Strasbourg, Strasbourg, France.
authors.forename: Michele
authors.initials: M
authors.lastname: Treger
authors.affiliation: Le Trait d'Union, HIV-infection care center, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
authors.forename: Constance
authors.initials: C
authors.lastname: De Miscault
authors.affiliation: Le Trait d'Union, HIV-infection care center, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
authors.forename: Marie-Laure
authors.initials: ML
authors.lastname: Batard
authors.affiliation: Le Trait d'Union, HIV-infection care center, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
authors.forename: Claudine
authors.initials: C
authors.lastname: Bernard-Henry
authors.affiliation: Le Trait d'Union, HIV-infection care center, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Cheneau
authors.affiliation: Le Trait d'Union, HIV-infection care center, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
authors.forename: Erik
authors.initials: E
authors.lastname: De Mautort
authors.affiliation: Le Trait d'Union, HIV-infection care center, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
authors.forename: Marialuisa
authors.initials: M
authors.lastname: Partisani
authors.affiliation: Le Trait d'Union, HIV-infection care center, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
authors.forename: Michele
authors.initials: M
authors.lastname: Priester
authors.affiliation: Le Trait d'Union, HIV-infection care center, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
authors.forename: David
authors.initials: D
authors.lastname: Rey
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D005602:France; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D008297:Male; D056990:Post-Exposure Prophylaxis / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012725:Sexual Behavior; D055815:Young Adult