暴露后预防在暴露前预防时代。
Post-exposure prophylaxis in the era of pre-exposure prophylaxis.
机构信息
Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.
出版信息
HIV Med. 2020 Nov;21(10):668-670. doi: 10.1111/hiv.12917. Epub 2020 Sep 9.
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.
目的
伦敦的一家性健康诊所 56 院长街（56DS）为英国四分之一的 HIV 性接触后预防（PEPSE）提供了服务。自 2015 年有限引入暴露前预防（PrEP）以来，PEPSE 的需求已经下降。
方法
我们对 2018 年 8 月在 56DS 接受 PEPSE 的个体进行了病历回顾。
结果
共给予 243 例 PEPSE；根据英国国家指南，97%（236 例）符合推荐的适应证。28 例（12%）有记录的先前 PrEP 使用；未服用 PrEP 的最常见原因是供应不足（15/28；54%）。截至 2020 年 4 月 1 日，在 215 例未使用过 PrEP 的患者中，有 106 例（49%）重新到 56DS 接受 PrEP 启动。
结论
在 56DS，PEPSE 适用于高危 HIV 暴露。对于使用 PrEP 的人，重要的是要支持他们的坚持，并确保供应充足。随着 PrEP 的使用增加，PEPSE 的需求可能会减少。
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