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Post exposure hiv prophylaxis

Derek D Satre, Andrea Altschuler, Sujaya Parthasarathy, Michael J Silverberg, Paul Volberding, Cynthia I Campbell
OBJECTIVES: This study examined implementation of the Affordable Care Act (ACA) in relation to HIV-positive patient enrollment in an integrated health care system; as well as changes in new enrollee characteristics, benefit structure and health care utilization after key ACA provisions went into effect in 2014. METHODS: This mixed-methods study was set in Kaiser Permanente Northern California (KPNC). Qualitative interviews with 29 KPNC leaders explored planning for ACA implementation...
October 3, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Carrie Llewellyn, Harriet Martin, Eileen Nixon
People who repeatedly present for post-exposure prophylaxis (PEP) for prevention of HIV following a high-risk sexual exposure are of concern according to the British HIV Association PEP guidelines. The aim of this audit was to determine the extent of repeat PEP prescriptions for men who have sex with men (MSM) by conducting a retrospective review of patient notes from a 5-year period at one genitourinary medicine clinic. Over the 5 years, 107 of 929 MSM (11.5%; 95% confidence interval: 9.45-13.55) received more than one PEP prescription (repeat range 1-8; mean=3...
October 7, 2016: Sexual Health
Susanna Naggie, David Holland, Mark S Sulkowski, David L Thomas
Currently, 380,000-400,000 occupational exposures to blood borne pathogens occur annually in the United States. The management for occupational HIV or HBV exposures includes post-exposure prophylaxis (PEP) when necessary; however, PEP is not recommended for HCV exposures. Recent approval of HCV direct acting antivirals (DAAs) has renewed discussions as to whether these therapies could be used to prevent infection after exposure. There are no published studies addressing this question but the prescribing of DAA for PEP has been reported...
September 28, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Naveen K Vaidya, Ruy M Ribeiro, Alan S Perelson, Anil Kumar
Complications of HIV-1 infection in individuals who utilize drugs of abuse is a significant problem, because these drugs have been associated with higher virus replication and accelerated disease progression as well as severe neuropathogenesis. To gain further insight it is important to quantify the effects of drugs of abuse on HIV-1 infection dynamics. Here, we develop a mathematical model that incorporates experimentally observed effects of morphine on inducing HIV-1 co-receptor expression. For comparison we also considered viral dynamic models with cytolytic or noncytolytic effector cell responses...
September 2016: PLoS Computational Biology
Ian McGowan, Charlene S Dezzutti, Aaron Siegel, Jarret Engstrom, Alexiy Nikiforov, Kathryn Duffill, Cory Shetler, Nicola Richardson-Harman, Kaleab Abebe, David Back, Laura Else, Deidre Egan, Saye Khoo, James E Egan, Ronald Stall, Peter E Williams, Khaleel K Rehman, Amy Adler, Rhonda M Brand, Beatrice Chen, Sharon Achilles, Ross D Cranston
BACKGROUND: Long-acting injectable antiretroviral agents are being developed for HIV-1 prevention. The MWRI-01 study was done to characterise the safety, acceptability, and pharmacokinetic and pharmacodynamic profile of long-acting rilpivirine. METHODS: We did a phase 1 open-label study at the University of Pittsburgh. We enrolled healthy individuals (aged 18-45 years) who were seronegative for HIV-1. Participants were assigned alternately one intramuscular dose of either 1200 mg or 600 mg long-acting rilpivirine, beginning with the 1200 mg dose...
September 16, 2016: Lancet HIV
J M Hugo, R D Stall, K Rebe, J E Egan, G De Swardt, H Struthers, J A McIntyre
Men who have Sex with Men (MSM) have been affected disproportionately by the global HIV pandemic. Rates of consistent condom-use are low and there is a need for further biomedical prevention interventions to prevent new HIV infections. Post exposure prophylaxis (PEP) can reduce the risk of HIV, but uptake among MSM is low. Pre-exposure prophylaxis (PrEP), an innovative anti-retroviral-based HIV prevention tool might be an appropriate intervention for MSM who have recently accessed PEP that involves HIV negative individuals taking daily tenofovir+emtricitabine for HIV prevention...
September 8, 2016: AIDS and Behavior
G Pialoux, C Delaugerre, L Cotte, F Raffi, E Cua, J-M Molina
The aim of preventive measures against human immunodeficiency virus (HIV) is to reduce the incidence of HIV infection in the general population and in high-risk groups, such as men having sex with men (MSM), and to reduce the risk that a given individual will contract or spread the virus. Male and female condoms, post-exposure prophylaxis and circumcision are preventive methods currently recognized or promoted worldwide. Although modest success has been reported in a phase-III vaccine trial, other methods are being evaluated, such as vaginal and rectal microbicides, and pre-exposure prophylaxis (PrEP)...
September 2016: Clinical Microbiology and Infection
Jose Castillo-Mancilla, Sharon Seifert, Kayla Campbell, Stacey Coleman, Kevin McAllister, Jia-Hua Zheng, Edward M Gardner, Albert Liu, David V Glidden, Robert Grant, Sybil Hosek, Craig M Wilson, Lane R Bushman, Samantha MaWhinney, Peter L Anderson
BACKGROUND: New objective measures of antiretroviral adherence are needed. We determined if emtricitabine triphosphate (FTC-TP) in dried blood spots (DBS) can be used as a marker of recent dosing to tenofovir disoproxil fumarate-emtricitabine (TDF-FTC). METHODS: The half-life of FTC-TP was estimated in DBS samples obtained from an intensive pharmacokinetic (PK) study of co-formulated TDF-FTC in HIV-negative and HIV-infected participants. The concordance of quantifiable FTC-TP in DBS with tenofovir (TFV)/FTC in plasma was evaluated utilizing paired plasma/DBS samples from participants enrolled in 2 large pre-exposure prophylaxis (PrEP) open-label trials...
August 29, 2016: Antimicrobial Agents and Chemotherapy
W Wy Sin, A Wc Lin, K Cw Chan, K H Wong
INTRODUCTION: Needlestick injury or mucosal contact with blood or body fluids is well recognised in the health care setting. This study aimed to describe the post-exposure management and outcome in health care workers following exposure to hepatitis B, hepatitis C, or human immunodeficiency virus (HIV) during needlestick injury or mucosal contact. METHODS: This case series study was conducted in a public clinic in Hong Kong. All health care workers with a needlestick injury or mucosal contact with blood or body fluids who were referred to the Therapeutic Prevention Clinic of Department of Health from 1999 to 2013 were included...
October 2016: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
J M Hugo, R D Stall, K Rebe, J E Egan, G Jobson, G De Swardt, H Struthers, J A McIntyre
The Soweto Men's Study (2008), demonstrated an overall HIV prevalence rate of 13.2 %, with 10.1 % among straight-identified Men-who-have-sex-with-men (MSM), 6.4 % among bisexual-identified MSM and 33.9 % among gay-identified MSM. Behavioral interventions are imperative, but insufficient to prevent new HIV infections. Biomedical prevention of HIV offers a variety of combination prevention tools, including Post-exposure prophylaxis (PEP). PEP studies amongst MSM have been conducted in Amsterdam, Brazil and San Francisco, but never before in Africa...
August 18, 2016: AIDS and Behavior
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
Svatava Snopková, Hanuš Rozsypal, Viktor Aster, Dalibor Sedláček, Jaroslav Kapla, Zdeňka Jerhotová, Lenka Olbrechtová, Alena Zjevíková, Pavel Dlouhý, David Jilich, Dan Veselý
Presented are general principles of care for HIV-infected persons following their admission to an AIDS care center, initiation of antiretroviral therapy and follow-up. Scientific research, drug development and new clinical data in recent years have led to a change in certain therapeutic perspectives and preferences for the treatment of HIV infection. Certain conditions are better specified, which affect the choice of antiretroviral regimens. Procedures and criteria for monitoring the effect of treatment and indication of post-exposure prophylaxis are specified...
March 2016: Klinická Mikrobiologie a Infekc̆ní Lékar̆ství
S M Ashrafur Rahman, Naveen K Vaidya, Xingfu Zou
While studies on pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) have demonstrated substantial advantages in controlling HIV transmission, the overall benefits of the programs with early initiation of antiretroviral therapy (ART) have not been fully understood and are still on debate. Here, we develop an immunity-based (CD4+ T cell count based) mathematical model to study the impacts of early treatment programs on HIV epidemics and the overall community-level immunity. The model is parametrized using the HIV prevalence data from South Africa and fully analyzed for stability of equilibria and infection persistence criteria...
October 2016: Mathematical Biosciences
Lorna Leal, Berta Torres, Agathe León, Constanza Lucero, Alexy Inciarte, Vicens Diaz-Brito, Elisa de Lazzari, José María Gatell, Felipe García
OBJECTIVE: To better target our current prevention strategies, we assessed factors associated with HIV seroconversion in individuals attending a specialized center after a risk exposure. MATERIALS AND METHODS: We studied individuals from an HIV Unit's contact risk cohort at a tertiary care hospital in Barcelona, Spain, between 2003 and 2013 and performed a retrospective matched case-control study. Cases were individuals who seroconverted to HIV after at least 3 months since first follow-up visit for a contracting risk...
October 2016: AIDS Research and Human Retroviruses
Preeti Pathela, Kelly Jamison, Sarah L Braunstein, Julia A Schillinger, Jay K Varma, Susan Blank
We examined five annual cohorts (2007-2011) of men who have sex with men (MSM) attending New York City STD clinics who had negative HIV-1 nucleic acid amplification tests (NAATs) on the day of clinic visit. Annual HIV incidence was calculated using HIV diagnoses within 1 year of negative NAAT, determined by matching with the citywide HIV registry. Predictors (demographic; behavioral; bacterial STD from citywide STD registry match) of all new HIV diagnoses through 2012 were calculated from Cox proportional hazards models...
July 23, 2016: AIDS and Behavior
Nicolas Lorente, Laura Fernàndez-López, Ricardo Fuertes, Daniela Rojas Castro, François Pichon, Bojan Cigan, Sophocles Chanos, Paula Meireles, Raquel Lucas, Stéphane Morel, Per Slaaen Kaye, Cristina Agustí, Irena Klavs, Tom Platteau, Jordi Casabona
INTRODUCTION: Community-based voluntary counselling and testing (CBVCT) services for men who have sex with men (MSM) can reach those most-at-risk and provide an environment for gay men that is likely to be non-stigmatising. Longitudinal data on the behaviour of HIV-negative MSM are scarce in Europe. The aim of this protocol, developed during the Euro HIV Early Diagnosis And Treatment (EDAT) project, is to implement a multicentre community-based cohort of HIV-negative MSM attending 15 CBVCT services in 5 European countries...
2016: BMJ Open
Patrick O'Byrne, Paul MacPherson, Marie Roy, Lauren Orser
HIV medications can be used as post-exposure prophylaxis to efficaciously prevent an HIV-negative person who has come into contact with HIV from becoming HIV-positive. Traditionally, these medications have been available in emergency departments, which have constituted a barrier for the members of many minority groups who are greatly affected by HIV transmission (i.e. gay, bisexual and other men who have sex with men, and persons who use injection drugs). From 5 September 2013 through 4 September 2015, we sought to increase the use of HIV post-exposure prophylaxis by having registered nurses provide these medications, when indicated, in community clinics in Ottawa, Canada...
July 12, 2016: International Journal of STD & AIDS
Rageshri Dhairyawan, Kate Shardlow, Michelle Carroll, Rachel Sacks
In 2006, a national survey demonstrated wide disparities in services offered to sexual assault complainants in the UK, most marked between sexual assault referral centres and non-sexual assault referral centres (police victim examination suites). With national standards introduced in 2009 and the expansion of sexual assault referral centres, we aimed to evaluate the current situation. A questionnaire based on the original 2006 survey, collecting data on population covered, access, funding, personnel, medical care and clinical governance was sent to all 44 UK sexual assault referral centres open in 2012...
July 8, 2016: International Journal of STD & AIDS
Joseph Schwartz, Josh Grimm
On May 14, 2014 the Centers for Disease Control and Prevention (CDC) endorsed the drug Truvada as an HIV preventative, called pre-exposure prophylaxis (PrEP). PrEP has been shown to dramatically reduce the risk of HIV infection, but its rate of adoption has been slow, and discourse surrounding it has been marked by stigma and uncertainty. The purpose of this study was to investigate how PrEP was discussed on Twitter. Our analysis focused on barriers to PrEP adoption and stigmatization of PrEP users. We analyzed a random sample of 1,093 top tweets about PrEP posted to Twitter a year before and a year after the CDC's endorsement...
June 13, 2016: Health Communication
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