Post-Exposure HIV Drugs Won't Boost Risky Behavior
January 23, 2008
Providing antiretroviral (ARV) treatment to people after they may have been exposed to HIV is an effective way to prevent them from becoming infected and does not appear to promote high-risk behavior in people who know this option is available, a new study finds. "This is a viable way of helping people stay [HIV-] negative," said Dr. Steve Shoptaw of the University of California-Los Angeles' Department of Family Medicine, who was involved in the research.
Post-exposure prophylaxis (PEP) has long been available in occupational settings. In 2005, CDC expanded its PEP guidelines to cover people exposed to HIV outside the workplace, including through condom breakage, risky sex or drug use. However, Shoptaw and colleagues note that PEP is not widely used in such cases, in part because it is not covered by health insurance and is only very rarely offered by community health programs.
To examine the feasibility of a non-occupational PEP program organized and funded by the community, the researchers conducted a demonstration project in which people were offered a 28-day course of ARVs within 72 hours of potential HIV exposure.
One hundred people, 95 of them men, enrolled in the project. Participants were provided drug treatment, HIV testing and counseling for up to 26 weeks after enrollment. Fifty-eight participants reported having unprotected anal sex, while 18 percent reported condom breakage.
Of the 84 people given the full course of ARVs, 75 percent actually took all the medicine. No one became HIV-positive during the study.
Shoptaw noted that some health officials have been hesitant to offer PEP after risky sex or drug use for fear that people would not change their behavior if they knew "there's a parachute somewhere they can take to stay negative." However, the researchers found people reduced their risky behavior after using PEP, rather than increasing it.
The researchers called for making non-occupational PEP more widely available to people at high risk of infection.
The study, "Non-Occupational Post Exposure Prophylaxis as a Biobehavioral HIV-Prevention Intervention" was published in AIDS Care (2007;doi:10.1080/09540120701660353).
11.23.2007; Anne Harding