Emory University, School of Medicine, Atlanta, Georgia.
VCU Health, School of Medicine, Richmond, Virginia, USA.
Curr Opin Pediatr. 2019 Aug;31(4):454-461. doi: 10.1097/MOP.0000000000000775.
Adolescents and young adults continue to contribute to new HIV infections despite improved antiretroviral regimens and HIV preexposure and postexposure prophylaxis (PrEP and PEP). Knowledge about nonoccupational HIV PEP (nPEP) is relevant and important for all pediatricians as adolescents present under a variety of circumstances disclosing past sexual activity.
nPEP is effective in preventing HIV infection, and newer regimens have been shown to increase compliance amongst users, have less side effects, and lead to less HIV resistance. Yet, research on physician prescription practices shows a lack of knowledge regarding appropriate HIV nPEP medication regimens, dosing, and follow-up recommendations. Updated national guidelines are available to providers who may be unfamiliar with indications and drug regimens for nPEP. Studies also provide different strategies to increase nPEP use and compliance among patients as well as ways to increase provider awareness of appropriate nPEP prescription.
Research of HIV nPEP shows that it is effective when used correctly, but there needs to be increased education and awareness to increase provider prescription and patient use as well as institutional changes to help patients complete the full course of medication.
尽管抗逆转录病毒疗法和 HIV 暴露前预防（PrEP）和暴露后预防（PEP）有所改善，但青少年和年轻人仍在继续导致新的 HIV 感染。了解非职业性 HIV 暴露后预防（nPEP）对于所有儿科医生都很重要，因为青少年在各种情况下出现，披露过去的性行为。
nPEP 可有效预防 HIV 感染，新的方案已被证明可提高使用者的依从性，减少副作用，并降低 HIV 耐药性。然而，关于医生处方实践的研究表明，对于 nPEP 药物方案、剂量和随访建议，医生缺乏相关知识。国家更新的指南提供给可能不熟悉 nPEP 适应证和药物方案的提供者。研究还提供了增加患者 nPEP 使用和依从性的不同策略，以及提高提供者对适当 nPEP 处方意识的方法。
nPEP 的 HIV 研究表明，当正确使用时，它是有效的，但需要加强教育和意识，以增加提供者的处方和患者的使用，并进行机构改革，以帮助患者完成整个疗程的药物治疗。
