School of Nursing, University of Ottawa, Ontario, Canada.
Sexual Health Clinic, Ottawa Public Health, Ottawa, Ontario, Canada.
J Int Assoc Provid AIDS Care. 2020 Jan-Dec;19:2325958220939763. doi: 10.1177/2325958220939763.
Patients who use post-exposure prophylaxis (PEP) are at ongoing risk for HIV acquisition after completing PEP. While the Centers for Disease Control and Prevention recommends pre-exposure prophylaxis (PrEP) use immediately after PEP, some practitioners are hesitant to offer PEP-to-PrEP (PEP2PrEP). We began offering PEP2PrEP in the sexually transmitted infection clinic in Ottawa, Canada on August 5, 2018. During the first 16 months of PEP2PrEP, 61 patients requested PEP and 46 were initiated; 30 of these patients agreed to PEP2PrEP and 26 followed through. None of our PEP patients had confirmed HIV exposures; all fulfilled the initiation criterion of condomless anal sex with a male partner of unknown HIV-status. During the study, the number of PEP requests and initiations was statistical unchanged, yet the seroconversion rate among patients who used PEP decreased from 1.7% pre-PEP2PrEP to 0% post-PEP2PrEP. Regarding follow-up, most discontinuations occurred between the PrEP intake and 1-month follow-up visit.
接受暴露后预防（PEP）的患者在完成 PEP 后仍持续存在 HIV 感染风险。虽然疾病控制与预防中心建议在 PEP 后立即使用暴露前预防（PrEP），但一些医生不愿意提供 PEP 至 PrEP（PEP2PrEP）。我们于 2018 年 8 月 5 日在加拿大渥太华的性传播感染诊所开始提供 PEP2PrEP。在 PEP2PrEP 的头 16 个月中，有 61 名患者要求接受 PEP，其中 46 名开始接受治疗；这些患者中有 30 人同意接受 PEP2PrEP，其中 26 人坚持完成。我们没有任何 PEP 患者有确认的 HIV 暴露；所有患者都符合未检测 HIV 状况的男性性伴侣无保护肛交的起始标准。在研究期间，要求接受 PEP 和开始治疗的人数没有明显变化，但接受 PEP 的患者的血清转化率从 PEP2PrEP 前的 1.7%降至 PEP2PrEP 后的 0%。关于随访，大多数停药发生在 PrEP 摄入和 1 个月随访之间。
