Preparing for HIV pre-exposure prophylaxis: lessons learned from post-exposure prophylaxis.
نویسندگان
چکیده
Although RCTs have not been conducted to establish the effıcacy of non-occupational postexposure prophylaxis (nPEP), studies in nonhuman primates have demonstrated protection with nPEP; observational data support the effıcacy of PEP for occupational exposures; and several studies have esablished the feasibility of nPEP delivery in various setings. Based on these data, the CDC and public health and rofessional organizations in many other western counries have issued recommendations regarding nPEP se. The effıcacy of pre-exposure prophylaxis (PrEP) or the prevention of HIV infection has now been demnstrated in several RCTs, the CDC has issued guidnce onPrEPuse, and demonstration projects are being planned to evaluate PrEP implementation in real-world settings. Lessons learned from nPEP programs could greatly inform these demonstration projects and the implementation of PrEP. San Francisco City Clinic, the only municipal sexually transmitted disease (STD) clinic in San Francisco, has maintained an nPEP program since 2002. This decade of experience provides a unique perspective on implementation of biomedicalHIVprevention interventions.Here, the authors’ programmatic experiencewith nPEP is highlighted, in order to consider lessons learned from its delivery in a public health clinic. Consideration is given in this paper to fıve key areas that influence the successful delivery of nPEP (Table 1): (1) knowledge of the intervention; (2) risk perception, risk evaluation, and the decision to initiate prophylaxis; (3) adherence; (4) risk compensation; and (5) access. Also highlighted are some of the key differences between nPEP and PrEP that underscore the distinct challenges of PrEP implementation (Table 2).
منابع مشابه
Lessons learned from the CDC's post-exposure prophylaxis program following the anthrax attacks of 2001.
متن کامل
British HIV Association guidelines for immunization of HIV-infected adults 2008.
Table of contents 1.0 Introduction 1.1 General principles of immunization in HIVinfected adults 1.2 Practical aspects of immunization and general contraindication 2.0 Anthrax 2.1 Background 2.2 Epidemiology and risk groups 2.3 Anthrax vaccine 2.3.1 Vaccine efficacy 2.3.2 Vaccine safety 2.4 Recommendations for anthrax pre-exposure prophylaxis in HIV-infected adults 2.5 Post-exposure prophylaxis ...
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عنوان ژورنال:
- American journal of preventive medicine
دوره 44 1 Suppl 2 شماره
صفحات -
تاریخ انتشار 2013