Post-exposure prophylaxis in the era of pre-exposure prophylaxis

HIV Med. 2020 Nov;21(10):668-670. doi: 10.1111/hiv.12917. Epub 2020 Sep 9.

Abstract

Objectives: 56 Dean Street (56DS), a sexual health clinic in London, provides a quarter of England's HIV post-exposure prophylaxis following sexual exposure (PEPSE). Since the limited introduction of pre-exposure prophylaxis (PrEP) in 2015, PEPSE demand has fallen.

Methods: We performed a case-note review of individuals who received PEPSE at 56DS in August 2018.

Results: Two hundred and forty three PEPSE were given; 97% (236) fitted recommended indications according to UK national guidance. Twenty-eight (12%) had documented prior PrEP use; the most common reason for not taking PrEP was lack of supply (15/28; 54%). Up to 1st April 2020, of 215 who had not previously used PrEP, 106 (49%) re-attended 56DS for PrEP initiation.

Conclusions: At 56DS, PEPSE is appropriately given for high-risk HIV exposures. For those who use PrEP, It is important to support their adherence and ensure adequate supply. As PrEP uptake increases, the need for PEPSE may decrease.

Keywords: HIV; post-exposure prophylaxis; pre-exposure prophylaxis.

MeSH terms

  • Adult
  • Female
  • HIV Infections / prevention & control*
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Patient Compliance / statistics & numerical data*
  • Post-Exposure Prophylaxis / statistics & numerical data*
  • Practice Guidelines as Topic
  • Pre-Exposure Prophylaxis / statistics & numerical data*
  • Sexual Health
  • United Kingdom