Weekly prescriptions for post-exposure prophylaxis after sexual exposure (PEPSE) at the 56 Dean Street clinic fell by over 80% during the first four weeks of the COVID-19 lockdown.
The London clinic, which in 2018 accounted for a quarter of the 12,000 PEPSE prescriptions issued in the UK, has maintained a walk-in service for the assessment and provision of PEPSE during lockdown. A newly published case note review compares prescriptions in the period 23 March to 19 April 2020 with a reference period of 20 January to 16 February 2020.
- Prescriptions fell from a peak of 54 in week commencing Feb 17 2020 to a low of just four in week commencing March 30–April 5.
- Men who had had unprotected receptive anal intercourse accounted for the majority of prescriptions in both four-week comparison periods, with no difference in the median age (32).
- However, HIV exposure during lockdown was more likely to involve sex facilitated by recreational drug use (chemsex).
It is not clear whether the fall in PEPSE prescriptions is due to a reduction in condomless sex during lcokdown or a reluctance to travel to the clinic, the authors say. In either case, promoting HIV testing during lockdown is important.
Lower levels of sexual activity would mean fewer individuals are in the 4-week window period for testing. The clinic has launched a social media campaign encouraging people at high risk of HIV to test before they resume usual sexual patterns, to prevent transmission from undiagnosed infection.