scholarly journals What do patients consulting in a free sexual health center know about HIV transmission and post-exposure prophylaxis?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Christelle Duteil ◽  
Elise de La Rochebrochard ◽  
Prescillia Piron ◽  
Christophe Segouin ◽  
Pénélope Troude

Abstract Background Screening, condom use and post-exposure prophylaxis (PEP) are among existing HIV prevention strategies. However, efficient use of these strategies requires that patients have an adequate knowledge of HIV transmission routes and awareness of risk behaviors. This study aimed to assess knowledge about HIV transmission among patients who attended a free HIV and sexually transmitted infection (STI) screening center in Paris, France, and to explore the patient profiles associated with HIV-related knowledge. Methods This observational cross-sectional study included 2002 patients who attended for STI testing from August 2017 through August 2018 and completed a self-administered electronic questionnaire. Based on incorrect answers regarding HIV transmission, two outcomes were assessed: lack of knowledge and false beliefs. Factors associated with these two outcomes were explored using univariate and multivariate logistic regressions. Results Only 3.6% of patients did not know about HIV transmission through unprotected sexual intercourse and/or by sharing needles. More than one third of patients (36.4%) had at least one false belief, believing that HIV could be transmitted by sharing a drink (9.7%), kissing (17.6%) or using public toilets (27.5%). A low educational level and no previous HIV testing were associated in multivariate analyses with both lack of knowledge and false beliefs. Age and sexual orientation were also associated with false beliefs. Furthermore, 55.6% of patients did not know that post-exposure prophylaxis consists of taking emergency treatment as soon as possible after risky intercourse. Conclusions Although the main HIV transmission routes are well known, false beliefs persist and knowledge regarding PEP needs to be improved. Prevention campaigns must focus on these themes which appear as a complementary strategy to pre-exposure prophylaxis to reduce HIV infection.

2020 ◽  
Author(s):  
Artur Acelino Francisco Luz Nunes Queiroz ◽  
Alvaro Francisco Lopes Sousa ◽  
Sonia Dias ◽  
Isabel Amélia Costa Mendes

Abstract AIM: We aim to characterize PEP and PrEP awareness in alarge national sample of Brazilian MSM. SUBJECT: Various disparities exist in HIV transmission among men who have sex withmen (MSM). Post-exposure Prophylaxis (PEP) and Pre-exposure prophylaxis (PrEP)has been shown as important strategies to prevent HIV, but there is variation in uptakewithin the MSM population. METHODS: This was a cross-sectional,population survey-based, analytical study, conducted exclusively online in all theregions of Brazil, with a sample of 2250 MSM. The multivariate logistic regressionmodel was adopted to produce adjusted odds ratios (ORa), considering a significancelevel at .05. RESULTS: We found a low knowledge about forms of prevention, with 54.6%claiming to know PEP and 46.4% PrEP. Men who did not recognize themselves ashomosexual, that is bisexual (ORa = 1.89, 95% CI 1.48-2.40) and heterosexual (ORa =3.83, 95% CI 2.80-5.24) were more likely to know the PEP. Having a higher minimumwage (ORa = 0.72, 95% CI 0.56-0.93) decreased the chances of knowing PrEP, aswell as having a higher level of education, factors that usually coexist, with thegraduate level being the highest of them (ORa = 0.13, 95% CI 0.06-0.28). CONCLUSION: Men still seem to know PEP from experience, after the failure of other preventivemeasures and not beforehand. PrEP awareness is permeated by barriers related tostructure and social determinants.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S521-S522
Author(s):  
Jennifer R Silva-Nash ◽  
Stacie Bordelon ◽  
Ryan K Dare ◽  
Sherrie Searcy

Abstract Background Nonoccupational post exposure prophylaxis (nPEP) following sexual assault can prevent HIV transmission. A standardized Emergency Department (ED) protocol for evaluation, treatment, and follow up for post assault victims was implemented to improve compliance with CDC nPEP guidelines. Methods A single-center observational study of post sexual assault patients before/after implementation of an ED nPEP protocol was conducted by comparing the appropriateness of prescriptions, labs, and necessary follow up. A standardized order-set based on CDC nPEP guidelines, with involvement of an HIV pharmacist and ID clinic, was implemented during the 2018-2019 academic year. Clinical data from pre-intervention period (07/2016-06/2017) was compared to post-intervention period (07/2018-08/2019) following a 1-year washout period. Results During the study, 147 post-sexual assault patients (59 Pre, 88 Post) were included. One hundred thirty-three (90.4%) were female, 68 (46.6%) were African American and 133 (90.4%) were candidates for nPEP. Median time to presentation following assault was 12.6 hours. nPEP was offered to 40 (67.8%) and 84 (95.5%) patients (P< 0.001) and ultimately prescribed to 29 (49.2%) and 71 (80.7%) patients (P< 0.001) in pre and post periods respectively. Renal function (37.3% vs 88.6%; P< 0.001), pregnancy (39.0% vs 79.6%; P< 0.001), syphilis (3.4% vs 89.8%; P< 0.001), hepatitis B (15.3% vs 95.5%; P< 0.001) and hepatitis C (27.1% vs 94.3%) screening occurred more frequently during the post period. Labratory, nPEP Prescription and Follow up Details for Patients Prescribed nPEP Conclusion The standardization of an nPEP ED protocol for sexual assault victims resulted in increased nPEP administration, appropriateness of prescription, screening for other sexually transmitted infectious and scheduling follow up care. While guideline compliance dramatically improved, further interventions are likely warranted in this vulnerable population. Disclosures Ryan K. Dare, MD, MS, Accelerate Diagnostics, Inc (Research Grant or Support)


Author(s):  
Nasima Iqbal ◽  
Faiza Quraishi ◽  
Muhammad Aslam Bhatti ◽  
Faizah Mughal ◽  
Tayyaba Mumtaz ◽  
...  

Aim: To find out the prevalence of needle stick injury, its reporting system and the reasons behind it. Study design: Descriptive cross-sectional Place and duration of study: Study was conducted at Jinnah post-graduate medical center (JPMC) Karachi during the period of March to September 2019 Methodology: A self-designed, self-explanatory questionnaire was used, consisting of two parts, the first part was about demographic information while second part is for information related to needle stick injury like probable cause, frequency, response after injury, post-exposure prophylaxis and about reporting of the incident. Questionnaire was validated by calculating the Cronbach’s alpha which was 0.78. data was analyzed by using the Statistical Package for the Social Sciences (SPSS) version 20. Results: Majority of the study participants were female (67.2%) and about 50% were postgraduate students. Out of total 134 doctors about 64.2% of the doctors had needle stick injury during their career. Finding out the most probable cause of needle stick injury during the survey it was found out that increased work load and prolonged working hours were the main reasons. Majority of the cases occurred in emergency department (41.9%). About 95.5% of the doctors didn’t get any post-exposure prophylaxis. Majority of the participants (96.3%) did not report to any authority because of the lack of knowledge about the reporting policy, it was noted that about 38.8% were confused either the reporting system exist or not. Most of the injuries occur during the procedure of suturing followed by recapping syringes. Conclusion: It has been concluded that majority of the doctors had faced needle stick injury during their career and a very negligible number of them got any post-exposure prophylaxis. Majority of them did not report to any authority. So there is a need of implication of safety measures and reporting policies for early detection and treatment of infections after needle stick injury.


2021 ◽  
pp. 4-6
Author(s):  
Chinmay Nandi ◽  
Saikat Bhattacharya ◽  
Soumitra Mondal ◽  
Shibasish Banerjee

Objectives -Rabies, an Endemic disease, is responsible for extensive morbidity and mortality in India. About 96% of the mortality and morbidity is associated with dog bites. The aim of the study was to estimate the prevalence and pattern of animal bites and rabies post exposure prophylaxis under National Rabies Control Programme Methodology – It was a Record cross sectional study where complete enumeration of all animal bite victims were done. Total 2940 such cases were found in that year. Data of 42 cases was excluded due to incomplete records. Data was analysed using MS Excel. Animal Bite Exposure register under National Rabies Control Programme, Patient Treatment cards, Consolidated reports were evaluated as study tools. Results - Majority of the wounds were found in limbs in 2695 (93%) cases. It is followed by wound in other areas like face 104(3.6%) and back 95 (3.3%). In a few cases site of wound was not mentioned in the case record. Children were most commonly affected (28.2%).Cat -bite is most common (49.3%). Around 84.9% were Category II bite and rest are category III. Conclusion - Dogs and cats are mostly responsible of animal bites in this part of the country. There is need to control stray dogs .Children are found to be most vulnerable for animal bites. There is gap between eligible candidates for vaccine and those who actually received it both in Category II and III animal bite victims.


2020 ◽  
Vol 27 (7) ◽  
Author(s):  
Christian Heitkamp ◽  
Daniel Robert Stelzl ◽  
Michael Ramharter ◽  
Silja Bühler

Abstract Background Rabies causes thousands of deaths worldwide and trips to rabies endemic countries are popular. Travellers are often uncertain whether pre-exposure prophylaxis (PrEP) is advisable since they find it difficult to estimate the exposure risk during travel and the availability of post-exposure prophylaxis in endemic regions. The aim of this study was to determine the potential rabies exposures in travellers and to assess their knowledge on rabies. Secondly, we explored the access to appropriate post-exposure medical care in respective countries. Methods We conducted a cross-sectional study at Frankfurt Airport. Returning adult travellers arriving from Asia, the Middle East, Africa, South and Central America were invited to participate in this questionnaire-based study while waiting in the baggage claim area. Results Over a one-month recruitment phase in March 2019, we enrolled 3066 travellers; 2929 were included in the analysis. The gender ratio was balanced; the median age was 42 years (range 18–83 years). Participants arrived from Asia (46%), Africa (29%), Central/South America (13%), the Middle East (8%) and the Caribbean (8%). Forty-five per cent sought pretravel advice and 22% received ≥2 injections of rabies PrEP. Travellers with pretravel advice from tropical medicine specialists reached significantly higher knowledge scores than others. We found that potential rabies exposure occurred in 2.0% (57/2915) of travellers with 31% (13/42) of the contacts being unprovoked; 19% (8/42) of the exposed sought medical care and 3/8 were adequately treated before returning to Germany. Risk factors for animal exposure were: male sex, young age, trips to Asia and a long stay abroad (>4 weeks). Conclusions A total of 2% of returning travellers (n = 2915) experienced a potential rabies exposure during their journey. A majority of the exposed individuals did not seek medical care; those seeking medical care were often treated inadequately. Rabies information must be emphasised during pretravel counselling and PrEP should be offered generously, especially to travellers with high exposure risks.


2018 ◽  
Vol 7 (1) ◽  
pp. 57-66
Author(s):  
Manu Thapa ◽  
Bishnu Gurung

Health care providers are at risk of acquiring human immunodeficiency virus (HIV) infection from occupational exposure, with nurses being the most vulnerable. Post exposure prophylaxis (PEP) of HIV is the only way to reduce risk of HIV after potential exposure. A study was conducted on Nurses Knowledge on PEP of HIV at Gandaki Medical College (GMC), Pokhara to find out the knowledge on PEP of HIV among nurses. Descriptive cross sectional research design was used for the study. Probability stratified systematic random sampling technique was used for sampling and self administered questionnaires was used for data collection with sample size of 90 nurses working in GMC. The data was analyzed using Statistical Package for Social Science (SPSS) version 20 software programme and presented in terms of frequency distribution, percentage, mean and standard deviation. For inferential statistics, chi square test was used at 5% level of significance. The findings of the study revealed that mean age of the respondents was 24.57 with standard deviation 3.43. Out of 90 respondents majority (83.3%) of the respondents were PCL passed and 47.8% of the respondents had adequate knowledge regarding PEP of HIV. The study found no significant association between demographic variables and knowledge level. It can be concluded that the nurses need to improve their level of knowledge on PEP of HIV by participating in different training programs. Health institution should also conduct continue nursing education programme to improve and update knowledge among the employees.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Betelhem Anteneh ◽  
Sewunet Admasu Belachew ◽  
Alem Endeshaw ◽  
Zewdu Birhanu Wubneh ◽  
Barun Ranjan Sarkar

Abstract Background HIV/AIDS in resource-limited settings poses a high risk of occupational exposure to healthcare workers due to higher number of HIV infected patients. Hence, antiretroviral based post-exposure prophylaxis (PEP) for HIV is very crucial. The aim of the study was to determine the knowledge, attitudes, and practices of medical and Health science students on antiretroviral based HIV PEP in University of Gondar comprehensive specialized hospital (UOGCSH), Northwestern Ethiopia. Methods An institutional-based cross-sectional study was conducted among 220 medical and health science graduating students in UOGCSH from May to July 2015. Data were collected using a self-administered pretested questionnaire. The collected data were analyzed using SPSS software version 22. Results were summarized in frequencies, percentages, and means with standard deviations and presented using tables or figures. Results Among the respondents, only sixty-six (30%) of the 220 study participants has had adequate knowledge about HIV PEP. Furthermore, over 90 % of the students had positive attitude towards HIV PEP f. Out of the total respondents, 37/220 (16.8%) were in need of HIV PEP and of these students only 18/37 (48.6%) took PEP. On the other hand, merely 50% of the study subjects completed the full course of HIV PEP, while the rest 50% failed to finish. As to the respondents self-report, the sole reason for starting but failing to complete the full course of HIV PEP was intolerance to the side effects of antiretroviral. Conclusions Although majority of the respondents had poor knowledge and practice, they owned a good attitude towards HIV PEP. Therefore, a pre-service intensive training for all students regarding HIV PEP prior to their clinical attachments is mandatory. In addition, potential side effects of ARTs and its managements should be priory informed to the students so as to prevent the associated non-adherence to ultimately reduce the incidence of drug resistance. Moreover, the habit of needle stick injury reporting was found to be poor that needs due improvement and there has been also a pressing need to supply sufficient protective barriers to the students while planning and rendering services.


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