Marseille 2007
| Abstract #285 - Prophylaxis after sexual exposure to HIV infection in south eastern France: physicians adherence, patients refusal and retention | ||||
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Session: 48.7: Behaviour and prevention (Parallel) on Wednesday @ 08.30-10.30 in CP Chaired by Michael Ross, Marie Preau Authors: Presenting Author: Mr Marc BENDIANE - National Institute for Health and Medical Research, France, Metropolitan |
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| Additional Authors: Dr Dominique REY, Ms Anne-Deborah BOUHNIK, Ms Maria-Patrizia CARRIERI, Dr Jesus ALMEDA, Prof Jean-Paul MOATTI, | ||||
| Aim: French national guidelines for the management of HIV non-occupational post-exposure were issued in 1998 and updated in 2003. Non-Occupational Post-Exposure Prophylaxis (nPEP) is available and free of charge in all emergency or AIDS care units of French hospitals. In the context of a large European project (EURONONOPEP) supported by the European commission, a local survey was carried out to study physicians adherence to national guidelines, factors associated with nPEP prescription and, for patients receiving nPEP, characterize determinants of retention in nPEP follow up. | ||||
| Method / Issue: The survey was carried out in the 3 regional AIDS centers which store the data of all individuals who have a consultation for nPEP in south eastern France. Retrospective data collection included information about exposed patient, type of exposure, and treatment at the first visit after exposure and during follow-up for all individuals aged 15 years or more who reported a sexual exposure between January 1st 2001 and December 31st 2002. In order to test whether physicians were adherent to nPEP prescription in case of sexual exposures, cases were classified into high risk (highly recommended), moderate risk (possibly recommended) and negligible risk (no recommended) categories, according to the level of HIV risk of sexual transmission as indicated by the French national nPEP guidelines. | ||||
| Results / Comments: Among the 910 cases reporting sexual exposures, to the level of HIV risk of sexual transmission was assessable for 97% of them: 56%, 37% and 4% were classified as cases with high, moderate and no risk respectively. NPEP was prescribed to 85% of patients. The level of HIV risk of sexual exposure was independently associated with nPEP receipt though more than half of individuals with negligible risk received nPEP. More than one third (37%)of patients receiving nPEP were not retained in treatment being the moderate risk more likely to be lost to follow up | ||||
| Discussion: Better information should be provided to physicians to limit nPEP over-prescription and strategies must be implemented to improve follow-up of treated patients, particularly youngest ones and survivors of sexual assault. | ||||
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