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Woodward SC, Baynes AM, Tyson HA, Dunlop WA, Martin SJ. Is non-occupational HIV Post Exposure Prophylaxis (nPEP) still used? An exploration of nPEP use since widespread availability of HIV PrEP. Int J STD AIDS 2022; 33:914-919. [PMID: 35853770 DOI: 10.1177/09564624221116527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Non-occupational Post-Exposure Prophylaxis (nPEP) is an effective HIV prevention strategy in gay and bisexual men (GBM) taken after possible exposure. HIV Pre-Exposure Prophylaxis (PrEP) is also a highly effective HIV prevention strategy. METHODS A retrospective audit of medical records of GBM presenting to a sexual health centre and provided with nPEP compared two periods to determine if nPEP usage changed following availability of PrEP. In the first period (P1) PrEP was available through extended trials. In the second period (P2) PrEP became more accessible through the Australian Pharmaceutical Benefits Scheme (PBS). Period comparisons were performed using a two-population test of proportions with one-tailed testing and significance set at P < .05 using SPSS Statistics Version 25. RESULTS There were 232 GBM provided with nPEP in P1, and 202 in P2. A two-population test of proportions demonstrated that GBM presentations for nPEP decreased significantly from 302/4779 (6.3%) of GBM visits in P1 to 221/7205 (3.1%) in P2 when PrEP was more accessible (Z=8.53, P < .001). PrEP uptake after presenting for nPEP increased from 30 (12.9%) of total GBM visits in P1 to 69 (34.2%) in P2 (Z=5.26, p < .001). CONCLUSIONS GBM accessing nPEP decreased with statistical significance post introduction of PBS PrEP.
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Affiliation(s)
- Shannon C Woodward
- Canberra Sexual Health Centre, 34381Canberra Health Services, Canberra, AU-ACT, Australia
| | - Anne M Baynes
- Canberra Sexual Health Centre, 34381Canberra Health Services, Canberra, AU-ACT, Australia
| | - Hayley A Tyson
- Canberra Sexual Health Centre, 34381Canberra Health Services, Canberra, AU-ACT, Australia.,Medical School, 2219Australian National University, Canberra, AU-ACT, Australia
| | - William A Dunlop
- Medical School, 2219Australian National University, Canberra, AU-ACT, Australia
| | - Sarah J Martin
- Canberra Sexual Health Centre, 34381Canberra Health Services, Canberra, AU-ACT, Australia.,Medical School, 2219Australian National University, Canberra, AU-ACT, Australia
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Crepalde-Ribeiro K, de Oliveira Costa J, Pearson SA, Silveira MR, Mendes JC, Dos Santos SF, Cruz MA, Braga MDG. Trends in HIV post-exposure prophylaxis following sexual exposure in Brazil (2011-2019). AIDS Behav 2022; 26:4115-4125. [PMID: 35841464 DOI: 10.1007/s10461-022-03737-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2022] [Indexed: 12/01/2022]
Abstract
We examined trends in the prevalence of post-exposure prophylaxis following sexual exposure (PEPSE) per million population (2011-2019) and the proportion of repeated PEPSE within 365 days of the first PEPSE dispensing (2011-2018) in Brazil. We also compared the prevalence of repeated PEPSE according to patient and health services characteristics in 2018. The prevalence of PEPSE increased 55.5% from 2011 to 2019. Repeated PEPSE increased 11.8%, reaching 8.4% among people with their first dispensing in 2018. The prevalence of repeated PEPSE was higher in cis men or trans women (versus cisgender women); homosexuals (versus heterosexuals); and people aged 25-29 years (versus other age groups). We also observed greater prevalence of repeated PEPSE in HIV services in populous cities or services with elevated caseloads. Our findings highlight the need for strategies to reduce repeated PEPSE and promote other HIV-prevention technologies, particularly among young adults, cisgender men, transgender women, and homosexuals.
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Affiliation(s)
- Kennedy Crepalde-Ribeiro
- Postgraduation Program in Medicines and Pharmaceutical Policy, Faculty of Pharmacy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | | | - Sallie-Anne Pearson
- School of Population Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia
| | - Micheline Rosa Silveira
- Postgraduation Program in Medicines and Pharmaceutical Policy, Faculty of Pharmacy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.,Department of Social Pharmacy, Faculty of Pharmacy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Jullye Campos Mendes
- Postgraduation Program in Medicines and Pharmaceutical Policy, Faculty of Pharmacy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Simone Furtado Dos Santos
- Postgraduation Program in Medicines and Pharmaceutical Policy, Faculty of Pharmacy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Márcio Afonso Cruz
- Postgraduate Program in Information Systems and Knowledge Management, Universidade FUMEC, Belo Horizonte, Minas Gerais, Brazil
| | - Maria das Graças Braga
- Postgraduation Program in Medicines and Pharmaceutical Policy, Faculty of Pharmacy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.,Department of Social Pharmacy, Faculty of Pharmacy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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