Emergency AIDS Treatment After Unsafe Sex Might Help
"We had strong statements in our informed consent [documentation indicating] that we did not know [whether] these drugs were effective, but 99% of participants accepted therapy and 78% completed all four weeks," Martin said during his part of the presentation. "There was a high rate of treatment compliance despite a high rate of adverse-event reporting," says Martin, referring to the sometimes crippling side effects associated with HIV therapy.
Martin, a researcher at UCSF, tells WebMD that the study proves there is a demand for PEP, and that people who need it can be identified and counseled, although the program attracted very few intravenous drug users. People with minimal exposures did not overwhelm the clinic -- probably because PEP is not a morning-after pill but rather four weeks of serious medication.
"We feel that the PEP setting may be a means of identifying persons difficult to reach with standard risk-reduction interventions," Martin says. However, there were some problems. "Twelve percent of the patients came back for additional therapy," he notes. "A handful of them came back a third or fourth time. We basically cut them off after four episodes."
The investigators tried to identify the source of HIV exposures in the PEP patients. While 31% of PEP recipients who knew that their source contact was HIV positive recruited that person for program participation, only 12% of those who did not know their contact's HIV status recruited that contact. But she says that the experience gained during the study will help improve this record. "I think we've learned some important lessons that maybe we can use to help [people bring in] their source contacts," she says.
Session moderator Mitchell Katz, MD, San Francisco Department of Public Health, also participated in the study. He admits that despite its successes, the PEP program reached only a fraction of eligible patients.
"The numbers in both these studies represent a very small proportion of people coming forward," Katz says. "There are an estimated 500 new sexually transmitted HIV infections in San Francisco every year. Since you have a tiny risk per exposure, then there is a lot of high-risk behavior going on to get 500 infections per year."