OBJECTIVE: The aim of the study was to describe the use of nonoccupational postexposure prophylaxis (NPEP) in Australia, and to estimate the number of HIV infections that its use prevented. METHODS: We conducted a population-based observational cohort study of people who presented to antiretroviral prescribers in Eastern Australia, and reported a high-risk nonoccupational exposure to HIV, in 1998-2004. Prescribers collected data at baseline, 4 weeks and 6 months. Data collected included details of HIV exposure, drug regimens and HIV serostatus. RESULTS: The great majority of the 1601 participants were male (95%) and presented after male homosexual exposure (87%). Only 32% of exposures were to HIV-positive sources. Two antiretroviral drugs were prescribed after 48% of events, and three or more drugs after 52% of events. The median time to receipt of NPEP was 23 h. Side effects were reported by 66% of participants. No case of NPEP failure in an adherent individual was identified. It was estimated that 0.9-9.2 HIV infections had been prevented. This compared with a total of 1138 newly acquired HIV infections notified in the geographical area covered by the study. CONCLUSIONS: In Australia, NPEP has been widely prescribed and is mainly targeted at high-risk exposures. Although there were no identified failures of NPEP, it is likely that only a small proportion of new HIV infections in the study area were prevented. NPEP may be a valuable preventive intervention for an individual, but it can only play a minor role in HIV prevention at the population level unless targeting can be further improved.
OBJECTIVE: The aim of the study was to describe the use of nonoccupational postexposure prophylaxis (NPEP) in Australia, and to estimate the number of HIV infections that its use prevented. METHODS: We conducted a population-based observational cohort study of people who presented to antiretroviral prescribers in Eastern Australia, and reported a high-risk nonoccupational exposure to HIV, in 1998-2004. Prescribers collected data at baseline, 4 weeks and 6 months. Data collected included details of HIV exposure, drug regimens and HIV serostatus. RESULTS: The great majority of the 1601 participants were male (95%) and presented after male homosexual exposure (87%). Only 32% of exposures were to HIV-positive sources. Two antiretroviral drugs were prescribed after 48% of events, and three or more drugs after 52% of events. The median time to receipt of NPEP was 23 h. Side effects were reported by 66% of participants. No case of NPEP failure in an adherent individual was identified. It was estimated that 0.9-9.2 HIV infections had been prevented. This compared with a total of 1138 newly acquired HIV infections notified in the geographical area covered by the study. CONCLUSIONS: In Australia, NPEP has been widely prescribed and is mainly targeted at high-risk exposures. Although there were no identified failures of NPEP, it is likely that only a small proportion of new HIV infections in the study area were prevented. NPEP may be a valuable preventive intervention for an individual, but it can only play a minor role in HIV prevention at the population level unless targeting can be further improved.
Authors: Sarah J McDougal; Jeremiah Alexander; Shireesha Dhanireddy; Robert D Harrington; Joanne D Stekler Journal: PLoS One Date: 2014-08-20 Impact factor: 3.240
Authors: Jean-Louis Excler; Wasima Rida; Frances Priddy; Jill Gilmour; Adrian B McDermott; Anatoli Kamali; Omu Anzala; Gaudensia Mutua; Eduard J Sanders; Wayne Koff; Seth Berkley; Patricia Fast Journal: AIDS Res Hum Retroviruses Date: 2010-12-16 Impact factor: 2.205
Authors: Françoise Barré-Sinoussi; Salim S Abdool Karim; Jan Albert; Linda-Gail Bekker; Chris Beyrer; Pedro Cahn; Alexandra Calmy; Beatriz Grinsztejn; Andrew Grulich; Adeeba Kamarulzaman; Nagalingeswaran Kumarasamy; Mona R Loutfy; Kamal M El Filali; Souleymane Mboup; Julio Sg Montaner; Paula Munderi; Vadim Pokrovsky; Anne-Mieke Vandamme; Benjamin Young; Peter Godfrey-Faussett Journal: J Int AIDS Soc Date: 2018-07 Impact factor: 5.396