Implementation of HIV non-occupational post-exposure prophylaxis for men who have sex with men in 2 cities of Southwestern China

Abstract

Non-occupational post-exposure prophylaxis (nPEP) has often relied on the joint work of emergency physicians and infectious disease specialists in busy emergency departments and human immunodeficiency virus (HIV)/sexually transmitted infections clinics abroad, where adherence education and follow-up are invariably reactive. In our pilot study, community-based organizations (CBOs) were invited to together implement the nPEP tailored to men who have sex with men (MSM) in 2 cities of Guangxi in Southwestern China, of which experiences and lessons drawn from would be provided to the promotion of nPEP in China.The study population enrolled MSM individuals prescribed nPEP from September 2017 to December 2019. One-to-one follow-ups by CBOs were applied through the treatment. Predictors of treatment completion were assessed by logistic regression.Of 271 individuals presented for nPEP, 266 MSM with documented treatment completion or non-completion, 93.6% completed the 28-day course of medication. Completion was associated with reporting side effects (aOR = .10; 95% CI: 0.02–0.38; P = .001). The follow-up rate of 91.9% was achieved based on the definition of loss to follow-up. No documented nPEP failures were found, although 1 MSM subsequently seroconverted to HIV due to ongoing high-risk behavior.CBOs’ engagement in HIV nPEP, especially the “one-to-one” follow-up supports by peer educators partly ensure adherence and retention to nPEP. Tailored interventions are needed to address the subsequent high-risk behaviors among the MSM population.

Evaluation of HIV Non-occupational Post-exposure Prophylaxis Utilisation in a Tertiary Health Facility in Nigeria

“…Another reason for the high preponderance of females may also be due to better female healthcare-seeking behaviours. [20] This finding is similar to that reported from Nigeria and Yaoundé, Cameroon, which belongs to the same geographical spread of West Africa. [9, 18,19] In contrast to the present study, Western countries show male predominance among those seeking nPEP, [16,21] probably because most of the patients in the western studies were men who have sex with men (MSM).…”

Understanding the Uptake and Outcomes of Non-occupational Postexposure Prophylaxis Use Through an Online Medical Platform in China: Web-Based Cross-sectional Study

“…In this study, 97.0% (523/539) of PEP users presumably completed the full 28-day course of medication, and this rate was higher than the completion rates in 2 other Chinese studies, where 86% [47] and 92.2% [41] of PEP users completed the 28-day course of medication, respectively. Furthermore, a systematic review and meta-analysis of 97 studies worldwide showed an even lower rate of PEP completion (67.2%; 95% CI 59.5%-74.9%) [48].…”

“…Over one-quarter of PEP users in this study reported prior PrEP usage, which was higher than that indicated by current limited data (12.1%) [41]. The reasons for this might include higher health awareness or more convenient access to HIV preventative services via the internet medical platform.…”

“…Although there are accumulating data on PEP need among MSM [24,41], characteristics common to PEP recipients in China have not been well described yet. In our study, most individuals seeking online PEP service were MSM, which may relate to the popularity of HeHealth among Blued users.…”

Awareness and Use of Post-exposure Prophylaxis for HIV Prevention Among Men Who Have Sex With Men: A Systematic Review and Meta-Analysis

“…PrEP and PEP are highly validated HIV prevention tools and are part of a wide range of prevention measures, including HIV testing, condom use, and screening and treatment for sexually transmitted infections ( 55 ). We should train community physicians in risk assessment, medication adherence assessment, and offline communication through online social media and offline posters, cards and brochures to promote PEP knowledge and inform them of ways to seek services ( 56 ). The completion and use of PEP has been shown to vary depending on the drug regimen.…”