Wednesday, January 7, 2009
Gay men often not accessing PEP despite risk of HIV exposure
Gay men may not be accessing HIV post-exposure prophylaxis in situations when its use would be warranted, a study published in the online edition of Sexually Transmitted Infections suggests.
Investigators in Brighton conducted interviews with 15 gay men who were currently taking, or had recently completed, a course of post-exposure prophylaxis after unprotected anal intercourse. They found that prior to accessing this treatment, the men generally had a poor understanding of what post-exposure prophylaxis involved.
The investigators also found that although the men described the sexual encounter leading to the accessing of post-exposure prophylaxis as unusual, they could almost all describe other circumstances where their risk behaviour was such that treatment with post-exposure prophylaxis would have been warranted. Furthermore, the interviews suggested that the men attempted to distance themselves from their risk behaviour, attributing it to the use of drugs and alcohol or in some way blaming their sexual partner.
Post-exposure prophylaxis (a short course of treatment with antiretroviral drugs after possible exposure to HIV) is becoming increasing available for individuals reporting sexual risk behaviour. The number of gay men presenting for such treatment has increased following targeted advertising campaigns and the publication of professional guidelines.
There is robust evidence that post-exposure prophylaxis can prevent infection with HIV. But there have been reports of HIV infection despite its use following possible sexual exposure to the virus. In many instances these infections can be attributed to ongoing sexual risk behaviour.
Investigators wished to gain a better understanding of the factors and rationale leading gay men to access post exposure prophylaxis. They were hopeful that the results of their study could lead to the development of health promotion campaigns targeting men who are not accessing this treatment after possible exposure to HIV.
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