PMID- 31603619 OWN - NLM STAT- MEDLINE DCOM- 20210601 LR - 20210601 IS - 1468-1293 (Electronic) IS - 1464-2662 (Print) IS - 1464-2662 (Linking) VI - 21 IP - 1 DP - 2020 Jan TI - Post-exposure prophylaxis for HIV infection in sexual assault victims. PG - 43-52 LID - 10.1111/hiv.12797 [doi] AB - OBJECTIVES: Sexual assault (SA) is recognized as a public health problem of epidemic proportions. Guidelines recommend the administration of post-exposure prophylaxis (PEP) after an SA. However, few data are available about the feasibility of this strategy, and this study was conducted to assess this. METHODS: We conducted a retrospective, longitudinal, observational study in SA victims attending the Hospital Clinic in Barcelona from 2006 to 2015. A total of 1695 SA victims attended the emergency room (ER), of whom 883 met the PEP criteria. Five follow-up visits were scheduled at days 1, 10, 28, 90 and 180 in the out-patient clinic. The primary endpoint was PEP completion rate at day 28. Secondary endpoints were loss to follow-up, treatment discontinuation, occurrence of adverse events (AEs) and rate of seroconversion. RESULTS: The median age of participants was 25 years [interquartile range (IQR) 21-33 years] and 93% were female. The median interval between exposure and presentation at the ER was 13 h (IQR 6-24 h). The level of risk was appreciable in 47% (n = 466) of individuals. Of 883 patients receiving PEP, 631 lived in Catalonia. In this group, the PEP completion rate at day 28 was 29% (n = 183). The follow-up rate was 63% (n = 400) and 38% (n = 241) at days 1 and 28, respectively. Treatment discontinuation was present in 58 (15%) of 400 patients who attended at least the day 1 visit, the main reason being AEs (n = 35; 60%). AEs were reported in 226 (56%) patients, and were mainly gastrointestinal (n = 196; 49%). Only 211 (33%) patients returned for HIV testing at day 90. A single seroconversion was observed in a men who have sex with men (MSM) patient at day 120. CONCLUSIONS: Follow-up and compliance rates in SA victims were poor. In addition, > 50% of the patients experienced AEs, which were the main reason for PEP interruption. Strategies to increase follow-up testing and new better tolerated drug regimens must be investigated to address these issues. CI - (c) 2019 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association. FAU - Inciarte, A AU - Inciarte A AUID- ORCID: 0000-0003-1896-3457 AD - Infectious Diseases Unit, Hospital Clinic of Barcelona, Barcelona, Spain. AD - University of Barcelona, Barcelona, Spain. AD - Institute of Biomedical Investigation August Pi and Sunyer, Barcelona, Spain. FAU - Leal, L AU - Leal L AD - Infectious Diseases Unit, Hospital Clinic of Barcelona, Barcelona, Spain. AD - University of Barcelona, Barcelona, Spain. AD - Institute of Biomedical Investigation August Pi and Sunyer, Barcelona, Spain. FAU - Masfarre, L AU - Masfarre L AD - University of Barcelona, Barcelona, Spain. FAU - Gonzalez, E AU - Gonzalez E AD - Infectious Diseases Unit, Hospital Clinic of Barcelona, Barcelona, Spain. FAU - Diaz-Brito, V AU - Diaz-Brito V AD - Infectious Diseases Unit, Hospital Clinic of Barcelona, Barcelona, Spain. AD - Hospital Sant Joan De DEU, Santa Boi, Spain. FAU - Lucero, C AU - Lucero C AD - Infectious Diseases Unit, Hospital Clinic of Barcelona, Barcelona, Spain. FAU - Garcia-Pindado, J AU - Garcia-Pindado J AD - University of Barcelona, Barcelona, Spain. FAU - Leon, A AU - Leon A AD - Infectious Diseases Unit, Hospital Clinic of Barcelona, Barcelona, Spain. AD - Institute of Biomedical Investigation August Pi and Sunyer, Barcelona, Spain. FAU - Garcia, F AU - Garcia F AD - Infectious Diseases Unit, Hospital Clinic of Barcelona, Barcelona, Spain. AD - University of Barcelona, Barcelona, Spain. AD - Institute of Biomedical Investigation August Pi and Sunyer, Barcelona, Spain. CN - Sexual Assault Victims Study Group LA - eng PT - Journal Article PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20191011 PL - England TA - HIV Med JT - HIV medicine JID - 100897392 RN - 0 (Anti-HIV Agents) SB - IM MH - Adult MH - Anti-HIV Agents/adverse effects/*therapeutic use MH - Female MH - HIV Infections/*prevention & control MH - Humans MH - Longitudinal Studies MH - Lost to Follow-Up MH - Male MH - Medication Adherence/statistics & numerical data MH - Post-Exposure Prophylaxis/*methods MH - Practice Guidelines as Topic MH - Retrospective Studies MH - Sex Offenses/*statistics & numerical data MH - Spain/epidemiology MH - Young Adult PMC - PMC6916272 OTO - NOTNLM OT - HIV infections OT - female OT - follow-up studies OT - patient compliance OT - post-exposure prophylaxis OT - sexual assault FIR - Manzardo, C IR - Manzardo C FIR - Nicolas, D IR - Nicolas D FIR - Bodro, M IR - Bodro M FIR - Del Rio, A IR - Del Rio A FIR - Cardozo, C IR - Cardozo C FIR - Cervera, C IR - Cervera C FIR - Pericas, J M IR - Pericas JM FIR - Sanclemente, G IR - Sanclemente G FIR - Garcia-Pindado, J IR - Garcia-Pindado J FIR - Cobos, N IR - Cobos N FIR - de la Calle, C IR - de la Calle C FIR - de la Calle, C IR - de la Calle C FIR - Morata, L IR - Morata L FIR - Soriano, A IR - Soriano A FIR - Espinosa, G IR - Espinosa G FIR - Echeverria, T IR - Echeverria T FIR - Cespedes, F IR - Cespedes F FIR - Farras, U IR - Farras U FIR - Rodriguez, D IR - Rodriguez D FIR - Martinez, B IR - Martinez B FIR - Suarez, M IR - Suarez M FIR - Gahete, A IR - Gahete A FIR - Santina, M IR - Santina M FIR - Garcia, L L IR - Garcia LL EDAT- 2019/10/12 06:00 MHDA- 2021/06/02 06:00 PMCR- 2019/12/17 CRDT- 2019/10/12 06:00 PHST- 2019/08/01 00:00 [accepted] PHST- 2019/10/12 06:00 [pubmed] PHST- 2021/06/02 06:00 [medline] PHST- 2019/10/12 06:00 [entrez] PHST- 2019/12/17 00:00 [pmc-release] AID - HIV12797 [pii] AID - 10.1111/hiv.12797 [doi] PST - ppublish SO - HIV Med. 2020 Jan;21(1):43-52. doi: 10.1111/hiv.12797. Epub 2019 Oct 11.