Postexposure prophylaxis: HIV PReP alternative option for select patients

  • Alghamdi A & al.
  • AIDS
  • 14 Nov 2019

  • International Clinical Digest
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Takeaway

  • Postexposure prophylaxis-in-pocket (PIP) may be a valuable preventative option for patients with low frequency of high-risk HIV exposures.

Why this matters

  • Consider PIP as an alternative to preexposure prophylaxis (PrEP) for a select group of patients with infrequent high-risk HIV exposure.
  • PIP is best for patients with high reliability, health literacy, and self-awareness characteristics.
  • Regular follow-up ensures patients are on some type of HIV prevention strategy.

Key results

  • 79 patients prescribed PIP; 94.9% (75) men who have sex with men; mean age, 37.5 (range, 21-70) years.
  • Mean PIP duration, 14.8 months; 40.5% had previously used PrEP.
  • 26.6% (21) initiated 32 PIP courses.
  • 100% of courses initiated ≤72 hours postexposure; self-reported 28 days adherence=100%.
  • No HIV seroconversions on subsequent testing.
  • Clinic follow-up rate, 91.1%.
  • Prior PrEP use was not prognostic for initiating PIP.
  • Patients initiating PIP >1 time were significantly more likely to switch modality from PIP to daily PrEP (P=.02).

Study design

  • Retrospective multicenter cohort analysis evaluating long-term follow-up of patient-initiated PIP for primary HIV prevention.
  • Funding: Canadian Institutes of Health Research.

Limitations

  • Small sample size.
  • Retrospective.
  • No control group.
  • Limited generalizability.