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Anna B Pierce, Carol El-Hayek, Damien McCarthy, Jude Armishaw, Kerrie Watson, Anna Wilkinson, Brian Price, Edwina J Wright, Jennifer F Hoy, Mark A Stoové
Background: International non-occupational post-exposure prophylaxis (NPEP) guidelines recommend routine use of three drug NPEP regimens, despite absence of evidence for greater prevention efficacy compared with two drug regimens. This study examines the potential for excess HIV seroconversions among high-risk men who have sex with men (MSM) reporting receptive anal intercourse with a source of unknown HIV serostatus (RAIU) following a two-drug versus a three-drug NPEP regimen. Methods: Data for MSM in the Victorian NPEP service database between 10 August 2005 and 31 December 2012 were linked with all Victorian HIV notifications up to 31 December 2013...
December 5, 2016: Sexual Health
Dawn K Smith, Emily Maier, Joshua Betts, Simone Gray, Brian Kolodziejski, Karen W Hoover
Community-based organizations (CBOs) are critical to delivery of effective HIV prevention because of their reach to key populations. This online survey of a national sample of CBOs assessed their awareness of, interest in, and resources needed to provide nonoccupational postexposure prophylaxis (nPEP), preexposure prophylaxis (PrEP), and HIV treatment as prevention (TasP). One hundred seventy-five CBOs participated: 87 clinical and 88 nonclinical CBOs. For nPEP, PrEP, and TasP, program managers reported that awareness was high (94%, 90%, 85%), meeting current client need was low (20%, 13%, 18%), and the likelihood of increasing their current provision with additional resources was somewhat high (62%, 64%, 62%)...
October 2016: AIDS Education and Prevention: Official Publication of the International Society for AIDS Education
Jason J Ong, Andre Landika, Christopher K Fairley, Catriona Bradshaw, Marcus Chen, Tim R H Read, Eric P F Chow
Background: Non-occupational post-exposure prophylaxis (NPEP) is available to people with a potential risk for HIV exposure within the preceding 72h. We sought to determine if men who have sex with men (MSM) and receive NPEP had a significantly different risk profile (before the preceding 72h) from MSM not receiving NPEP. If this is the case, NPEP consultations may act as a cue for also discussing pre-exposure prophylaxis. Methods: We conducted a retrospective analysis to compare the demographic characteristics, sexual practices and clinical diagnoses of MSM who were NPEP users and those who were non-NPEP users attending Melbourne Sexual Health Centre from January 2008 to December 2014...
August 19, 2016: Sexual Health
S Y Lin, N J Lachowsky, M Hull, A Rich, Z Cui, P Sereda, J Jollimore, K Stephenson, M Thumath, Jsg Montaner, E A Roth, R S Hogg, D M Moore
OBJECTIVES: Nonoccupational post-exposure prophylaxis (nPEP) is a strategy to reduce the risk of HIV infection in those with high-risk exposure. This study characterized nPEP awareness among gay, bisexual and other men who have sex with men (MSM) in Metro Vancouver, British Columbia, Canada after a pilot nPEP programme established in 2012. METHODS: Momentum Health Study participants were MSM aged ≥16 years recruited via respondent-driven sampling (RDS) who completed a computer-assisted self-interview...
October 2016: HIV Medicine
(no author information available yet)
New evidence-based guidelines, Updated Guidelines for Antiretroviral Postexposure Prophylaxis after Sexual, Injection-Drug Use, or Other Nonoccupational Exposure to HIV - United States, 2016, are now available online ( The guidelines update and expand the 2005 U.S. Department of Health and Human Services recommendations for clinical care providers regarding nonoccupational postexposure prophylaxis (nPEP) for exposure to human immunodeficiency virus (HIV) outside the health care setting for persons in the United States (1)...
May 6, 2016: MMWR. Morbidity and Mortality Weekly Report
Stefano Malinverni, Agnès Libois, Anne-Françoise Gennotte, Cécile La Morté, Pierre Mols
We conducted a retrospective analysis of data from a prospective nPEP (non-Occupational Post Exposure Prophylaxis) registry based on patients consulting at one academic Emergency department located in Brussels, Belgium. We review here 1,357 cases consulting from January 2011 to December 2013.The objective of the study is to determine whether emergency physicians prescribe nPEP according to national guideline with support from IDS (infectious disease specialists). As this intervention has a high cost we wanted to verify correct allocation of treatment to high risk patients...
2016: PloS One
Omar Martinez, Elwin Wu, Ethan C Levine, Miguel Muñoz-Laboy, M Isabel Fernandez, Sarah Bauerle Bass, Eva M Moya, Timothy Frasca, Silvia Chavez-Baray, Larry D Icard, Hugo Ovejero, Alex Carballo-Diéguez, Scott D Rhodes
INTRODUCTION: Successful HIV prevention and treatment requires evidence-based approaches that combine biomedical strategies with behavioral interventions that are socially and culturally appropriate for the population or community being prioritized. Although there has been a push for a combination approach, how best to integrate different strategies into existing behavioral HIV prevention interventions remains unclear. The need to develop effective combination approaches is of particular importance for men who have sex with men (MSM), who face a disproportionately high risk of HIV acquisition...
2016: PloS One
Jason W Mitchell, Amber I Sophus, Andrew E Petroll
PURPOSE: Non-occupational post-exposure prophylaxis (nPEP) is an underutilized biomedical option for HIV prevention. Few studies have assessed male couples' knowledge of and willingness to use nPEP. METHODS: Cross-sectional dyadic data from 275 HIV-negative and 58 HIV-discordant male couples were used to describe HIV-negative, partnered men's awareness and willingness to use nPEP, and factors associated with their willingness to use nPEP. Data were analyzed with the use of multivariate multilevel modeling...
April 2016: LGBT Health
Jessica E Draughon Moret, William E Hauda, Bonnie Price, Daniel J Sheridan
BACKGROUND: Nonoccupational postexposure prophylaxis (nPEP) for HIV following sexual assault may decrease the likelihood of HIV transmission. OBJECTIVE: The purpose of this exploratory chart review study was to examine factors associated with patients accepting post-sexual assault nPEP at three forensic nurse examiner programs in urban settings. METHODS: Forensic nursing charts of patients presenting for acute sexual assault care were reviewed as part of a mixed-methods study...
January 2016: Nursing Research
Nirojini Sivachandran, Reed A C Siemieniuk, Pauline Murphy, Andrea Sharp, Christine Walach, Tania Placido, Isaac I Bogoch
Data evaluating the screening practices for viral hepatitides and sexually transmitted infections (STIs) in patients presenting for non-occupational HIV post-exposure prophylaxis (nPEP) care are limited. Screening practices and prevalences of viral hepatitides and STIs were evaluated in 126 patients presenting to a dedicated HIV prevention clinic for HIV nPEP. Three patients (2.4%) were diagnosed with chronic hepatitis C infection, 28 (22.2%) did not have surface antibodies in sufficient quantity to confer immunity to hepatitis B, and six (4...
November 2015: International Journal of Infectious Diseases: IJID
Yasufumi Kato, Haruhiko Nakamura, Hiromasa Tojo, Masaharu Nomura, Toshitaka Nagao, Takeshi Kawamura, Tatsuhiko Kodama, Tatsuo Ohira, Norihiko Ikeda, Thomas Fehniger, György Marko-Varga, Toshihide Nishimura, Harubumi Kato
BACKGROUND: In the new pathologic classification of lung adenocarcinoma proposed by IASLC/ATS/ERS in 2011, lepidic type adenocarcinomas are constituted by three subtypes; adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA) and lepidic predominant invasive adenocarcinoma (LPIA). Although these subtypes are speculated to show sequential progression from preinvasive lesion to invasive lung cancer, changes of protein expressions during these processes have not been fully studied yet...
December 2015: Clinical and Translational Medicine
Reed A C Siemieniuk, Nirojini Sivachandran, Pauline Murphy, Andrea Sharp, Christine Walach, Tania Placido, Isaac I Bogoch
The uptake of pre-exposure prophylaxis (PrEP) for HIV prevention remains low. We hypothesized that a high proportion of patients presenting for HIV non-occupational post-exposure prophylaxis (nPEP) would be candidates for PrEP based on current CDC guidelines. Outcomes from a comprehensive HIV Prevention Clinic are described. We evaluated all patients who attended the HIV Prevention Clinic for nPEP between January 1, 2013 and September 30, 2014. Each patient was evaluated for PrEP candidacy based on current CDC-guidelines and subjectively based on physician opinion...
August 2015: AIDS Patient Care and STDs
Neha Gupta, Heidi Schmidt, Timothy Buisker, Mi-Suk Kang Dufour, Joe Goldenson, Janet Myers, Jacqueline Tulsky
Women who have been in jail are at increased risk of acquiring HIV when they are in the community. Nonoccupational postexposure prophylaxis (nPEP) reduces HIV transmission following high-risk behaviors and is an effective HIV prevention strategy. The authors designed a 15-minute interactive educational program to increase inmates' knowledge of nPEP. Before the program, participants self-reported high HIV risk yet low risk perception and lack of nPEP awareness. After the program, nPEP knowledge scores increased by 40% regardless of demographic or HIV-risk characteristics...
April 2015: Journal of Correctional Health Care
Sachin Jain, Catherine E Oldenburg, Matthew J Mimiaga, Kenneth H Mayer
A paucity of information regarding mental health exists for patients presenting for HIV non-occupational post-exposure prophylaxis (nPEP). We reviewed electronic medical records of 894 adult nPEP patients seen at a large Boston community health center between 1997 and 2013. Of 821 patients with consensual sexual exposures, 88.3 % were men who have sex with men, and 40.0 % had a mental health diagnosis. Diagnoses included: depression (24.4 %), anxiety (21.9 %), attention deficit disorder (7.8 %), post-traumatic stress disorder (3...
July 2016: AIDS and Behavior
Sachin Jain, Catherine E Oldenburg, Matthew J Mimiaga, Kenneth H Mayer
Non-occupational post-exposure prophylaxis (NPEP) has been recommended to prevent HIV acquisition for nearly 20 years. However, limited behavioral and clinical outcome data exist after men who have sex with men (MSM) present for NPEP. We reviewed the electronic medical records of HIV-uninfected adults who presented for NPEP at a large community health center in Boston between July, 1997 and August, 2013. Data from 894 patients were analyzed, 88.1% of whom were MSM. Consensual unprotected sex was the most common reason for NPEP visits among MSM (64...
January 2015: AIDS Patient Care and STDs
Sachin Jain, Catherine E Oldenburg, Matthew J Mimiaga, Kenneth H Mayer
Secular trends in nonoccupational postexposure prophylaxis (NPEP) use have not been well characterized. We performed a retrospective longitudinal study of 894 electronic medical records of NPEP users, mostly men who have sex with men, at a Boston community health center who presented between July 1997 and August 2013. NPEP use and condomless sexual exposures increased over time; 19.4% had multiple NPEP courses. Having an HIV-infected partner was associated with increased odds of regimen completion, and 3-drug regimens were associated with decreased odds of completion...
January 1, 2015: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Laura J Fitzpatrick, Daniel J Egan, Ethan Cowan, Leah M Savitsky, John D Kushner, Yvette Calderon, Bruce D Agins
New York State (NYS) established guidelines for nonoccupational post-exposure prophylaxis (nPEP) to HIV in 1997. To assess current nPEP practices in NYS Emergency Departments (EDs), we electronically surveyed all ED directors in NYS, excluding Veterans' Affairs hospitals, about nPEP and linkage-to-care protocols in the EDs. Basic descriptive statistics were used for analysis. The response rate was 96% (184/191). Of respondents, 88% reported evaluating any patient with a possible nonoccupational exposure to HIV, in accordance with NYS guidelines...
November 2014: Journal of the International Association of Providers of AIDS Care
Sarah J McDougal, Jeremiah Alexander, Shireesha Dhanireddy, Robert D Harrington, Joanne D Stekler
Despite treatment guidelines in place since 2005, non-occupational post-exposure HIV prophylaxis (nPEP) remains an underutilized prevention strategy. We conducted a retrospective chart review of patients presenting to a publicly-funded HIV clinic in Seattle, Washington for nPEP between 2000 and 2010 (N = 360). nPEP prescriptions were provided for 324 (90%) patients; 83% of prescription decisions were appropriate according to Centers for Disease Control and Prevention guidelines, but only 31% (N = 111/360) of patients were considered "high risk...
2014: PloS One
Kathleen H Krause, Annie Lewis-O'Connor, Amanda Berger, Teress Votto, Sigal Yawetz, Daniel J Pallin, Lindsey R Baden
BACKGROUND: Comprehensive data that address current HIV nonoccupational postexposure prophylaxis (nPEP) practices in the emergency care of sexual assault patients are limited. The U.S. Centers for Disease Control and Prevention released HIV nPEP guidelines in 2005 and updated guidelines for Sexually Transmitted Disease Treatment in 2006 and 2010, each of which support providing nPEP to sexual assault patients. This study examined the offer, acceptance, and adherence rates of nPEP among sexual assault patients treated at an emergency department (ED)...
July 2014: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
Susanne Doblecki-Lewis, Michael A Kolber
Data supporting the use of pre-exposure prophylaxis (PrEP) and nonoccupational postexposure prophylaxis (nPEP) in the prevention of HIV infection after a sexual encounter continue to grow. In this review, we describe some of the research driving the various recommendations for use of antiretrovirals in prevention. In addition, current research is described regarding the establishment of viral reservoirs that argues for rethinking the timing for nPEP treatment. We discuss the variables that impact on the choice of prevention antiretrovirals, including drug distribution, drug transporters, and potential impact of race and ethnicity on these variables...
July 2014: IUBMB Life
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