scholarly journals P20 Potential impact of updated UK guidelines for use of post exposure prophylaxis following sexual exposure in a London sexual health service

2012 ◽  
Vol 88 (Suppl 1) ◽  
pp. A17.1-A17
Author(s):  
L Snell ◽  
S G Edwards ◽  
P D Benn
2019 ◽  
Vol 30 (9) ◽  
pp. 911-914
Author(s):  
Billakanti Swarna Kumari ◽  
Shyamalie Bopitiya ◽  
Anne Bassinder ◽  
Satyajit Das

The management of victims of sexual assault need a holistic approach. The British Association of Sexual Health and HIV (BASHH) has set up standards for the management of sexual assault victims attending Sexual Health Clinics. We audited the management of victims of sexual assault attending an integrated sexual health service against recommendations from the latest BASHH guidelines. We included the recommendations and implementations already in place following an earlier audit in 2013 using the same guideline. Sixty-seven individuals identified themselves as victims of sexual assault. Most were of white ethnic origin (78%), female (96%) and the commonest age group was 18–25 years (39%). We achieved the 100% target in recording the date of assault, offering baseline sexually transmitted infection (STI) screening, HIV risk assessment, offer of post-exposure prophylaxis (PEP) for HIV where applicable and offer of emergency contraception. We were below the 100% target for other categories but improved compared to the previous audit except in recording the time when the first dose of PEP for HIV was given. The BASHH guideline has 14 auditable standards, all with a target of 100%. Our audit cycle completed in three years showed considerable improvement in achieving the standards in the management of Sexual Assault Victims. We hope this will encourage other centres audit their practice against the standards set by BASHH.


Sexual Health ◽  
2013 ◽  
Vol 10 (5) ◽  
pp. 438 ◽  
Author(s):  
Trine Gulholm ◽  
Salina Jamani ◽  
I. Mary Poynten ◽  
David J. Templeton

Background Non-occupational HIV post-exposure prophylaxis (NPEP) is prescribed following a risk exposure in an effort to reduce the risk of HIV seroconversion. We aimed to describe the prescribing practices of NPEP at RPA Sexual Health in Sydney, the prevalence and correlates of adverse events (AEs), and factors associated with completing the 28-day course. Methods: The study population included individuals prescribed NPEP during January 2008–December 2011. Correlates of AEs and course completion were assessed by logistic regression. Results: On 319 occasions during the study period, 282 individuals presented for NPEP. Over 90% of presentations followed unprotected anal intercourse between men, mostly receptive (63.6%). Tenofovir–emtricitabine–stavudine (n = 149; 46.7%) and tenofovir–emtricitabine (n = 136; 42.6%) were most commonly prescribed. AEs were reported at 101 presentations (31.7%, 95% confidence interval (CI): 26.6–37.1%), with nausea and lethargy/malaise being the most common. Younger age (P for trend = 0.032), earlier year of NPEP prescription (P for trend = 0.011), being prescribed a regimen other than tenofovir–emtricitabine (P = 0.026), changing the NPEP regimen (P < 0.001) and known completion of the course (P = 0.005) were independently associated with AEs. The course was completed in 228 presentations (71.5%, 95% CI: 66.2–76.4%). Completion was associated with reporting AEs (P = 0.007) and changing regimen (P = 0.001). No documented NPEP failures were identified, although two recipients subsequently seroconverted to HIV due to ongoing high-risk behaviour. Conclusions: NPEP is appropriately targeted to the highest risk HIV exposures at our clinic. Active recall may improve follow-up rates in NPEP recipients.


Author(s):  
Risqa Novita

Abstrak Rabies di Indonesia telah berada sejak abad 18, namun hingga saat ini Indonesia belum bebas dari rabies. Hanya 8 provinsi di Indonesia yang bebas dari rabies yaitu DKI Jakarta, Jawa Tengah, Jawa Timur, Daerah Istimewa Yogyakarta, Bangka Belitung, Kepulauan Riau, Papua, dan Papua Barat, padahal Indonesia ditargetkan bebas rabies pada tahun 2030. Rabies tidak dapat diobati karena disebabkan oleh virus Lyssa, hanya dapat dicegah melalui pendekatan One Health yaitu kesehatan manusia, kesehatan hewan, satwa liar dan kesehatan lingkungan. Upaya pencegahan itu adalah dengan pemberian vaksinasi rabies ke Hewan Pembawa Rabies (HPR) dan pemberian Post Exposure Prophylaxys (PEP) pada manusia yang tergigit oleh HPR. Pemberian PEP hanya dapat dilakukan di Rabies center atau fasilitas pelayanan kesehatan primer yang ditunjuk oleh pemerintah. Tulisan ini bertujuan untuk mengetahui peranan fasilitas pelayanan kesehatan untuk mengendalikan rabies yang sudah tersebar di 26 provinsi. Metode berupa review literatur yang dicari menggunakan kata kunci Pelayanan Kesehatan Primer, Post Exposure Prophylaxis dan Rabies di Indonesia. Hasil yang didapatkan adalah peran fasilitas pelayanan kesehatan dalam mengendalikan rabies pada manusia sangat penting, dalam hal tatalaksana pertama kali terhadap korban penyediaan Vaksin Anti Rabies (VAR) dan promosi kesehatan. Rabies dapat dicegah dengan perilaku hidup sehat, sehingga peran fasilitas pelayanan kesehatan yang ditunjuk sebagai Rabies center dapat mengoptimalkan promosi kesehatan melalui pemberian leaflet, edukasi rabies di sekolah-sekolah dasar, pemasangan spanduk rabies dan pemutaran video rabies di puskesmas atau rumah sakit di ruang tunggu pasien sehingga pasien dapat melihat dan mengetahui mengenai rabies dan pencegahannya. Kata kunci: pelayanan kesehatan, post exposure prophylaxis, dan rabies center Abstract Rabies has been in Indonesia since the 18th century, but until now Indonesia has not been free from rabies yet. Only 8 provinces in Indonesia are free from rabies, namely DKI Jakarta, Central of Java, East of Java, Jogyakarta, Bangka Belitung, The Riau Islands, Papua, and West Papua. Rabies could not be treated because it caused by the virus (named Lyssavirus), which only prevented by the approach of one health in human health, animal health and wildlife animals, and environmental health. Lyssa could be prevented by a rabies vaccine program to rabid animals and post-exposure prophylaxis (PPE) in humans who bitten by rabid animals. The provision of the PPE can only be done in Rabies center or primary health service facilities designated by the government. This writing aims to know the role of health service facilities in primary or public health centers to tackle rabies which has been spread in 26 provinces. A method of review literature that sought to use the keywords was Health services in primary, Post-exposure prophylaxis, and Rabies in Indonesia. Results were the role of health service facilities in the control of rabies in humans is very important, in terms of managing the provision of VAR and the promotion of health service. Rabies can be prevented with healthy patterns of living so that the role of health service facilities which was appointed for rabies center can optimize the promotion of health through the provision of leaflets, education in primary schools, setting banners rabies and screening of rabies in video health center or hospital patients in the waiting room so that the patient can see and know what rabies and it prevents. Keywords: health services, post-exposure prophylaxis, and rabies center


2020 ◽  
Vol 31 (5) ◽  
pp. 426-431
Author(s):  
Karen Biggs ◽  
Maree O’Sullivan ◽  
Cheryn Palmer ◽  
Jacqualine McLellan ◽  
Fiona Marple-Clark ◽  
...  

Both post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP) involve the use of antiretroviral drugs taken by HIV-uninfected individuals to reduce HIV acquisition risk. While PEP has been available in Australia for many years, PrEP became widely accessible in 2018 after listing on the Pharmaceutical Benefits Scheme (PBS). Studies have reported on the impact of PrEP on condom use. The impact of PrEP on the use of PEP in Australia has not been reported. This project examined PEP use across three public sexual health services in South-East Queensland, Australia, comparing rates in 2016 (prePBS-listed PrEP) and 2019 (postPBS-listed PrEP), to determine if PEP prescribing, and the characteristics of people accessing PEP, have changed. Results showed that PEP prescribing made up 2.85% of all clients seen in 2016, dropping to 2.33% in 2019, reflecting a decrease of 0.5% (p = 0.048). There was a significant increase in Medicare-ineligible clients accessing PEP (9% in 2016; 21% in 2019; p = 0.002) and a significant increase in PrEP-experienced clients accessing PEP between the two study periods (4% in 2016; 14% in 2019; p ≤ 0.001). The marginal decrease in PEP prescribing highlights that PEP remains an important option especially for those with barriers to accessing and adhering to daily PrEP.


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