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

• Published in: HIV medicine Vol. 21; no. 10; pp. 668 - 670
• Main Authors: Atim, M, Girometti, N, Hyndman, I, McOwan, A, Whitlock, G, Gedela, Keerti, McCormack, Sheena, Nugent, Diarmuid, Patel, Sheel, Suchak, Tara, Tittle, Victoria
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-11-2020
• Subjects: Exposure; Health risks; HIV; Human immunodeficiency virus; post‐exposure prophylaxis; pre‐exposure prophylaxis; Prophylaxis; Sexually transmitted diseases; STD; HIV; post-exposure prophylaxis; pre-exposure prophylaxis
• ISSN: 1464-2662; 1468-1293
• DOI: 10.1111/hiv.12917

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.