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1st appeared
27 September
1999 Failures Following HIV Post-Exposure Prevention Provide Valuable Lessons Clinicians and prevention programs must address misconceptions and provide ongoing counseling on transmission risks in order to prevent HIV, according to UCSF researchers. Patients enrolled in the San Francisco Post-Exposure Preventive (PEP) Project became infected with HIV more than six months after their initial exposure to the virus because of subsequent and ongoing contact with HIV-infected partners. Four case studies were presented at the Interscience Conference on Anti-Microbial Agents and Chemotherapy on September 26 in San Francisco. "Clinicians and prevention programs need to help people understand the increased risk of becoming infected through repeated exposures to HIV," said Michelle Roland, assistant professor of medicine, UCSF Positive Health Program at San Francisco General Hospital Medical Center and lead author of the study. "The most important thing we can do is help people identify barriers to protecting themselves and offer resources to overcome those barriers." The PEP project, jointly run by the UC San Francisco AIDS Research Institute and the San Francisco Department of Public Health, offers comprehensive treatment to high-risk sexually active people and injection drug users who may have been exposed to HIV. Treatment includes HIV testing, risk-reduction counseling, and anti-viral drug intervention. The project enrolled 436 persons exposed to HIV and provided services for almost 500 HIV exposures between October, 1997 and April, 1999. After four weeks of counseling and anti-retroviral therapy, none of the exposed individuals became infected. However, four patients have subsequently become infected at least six months after their initial exposure to the virus. Three experienced seroconversion, the point at which HIV antibodies reach a detectable level in the blood and HIV infection is confirmed. A fourth person showed symptoms of acute HIV infection, a condition where the virus can be seen in the plasma but antibodies are yet to be produced. "We identified two barriers that clinicians and prevention programs should address based on the four case histories," said Roland. "First, counseling strategies should target common misconceptions about transmission among both HIV positive and HIV negative people. And, second, it is important to provide risk-reduction counseling and referrals in conjunction with anti-viral drug regimes." Links: Related stories: Post-Exposure Program Unveils Innovative Ads SFGH Sets National Model for HIV Prevention Intervention HIV Post-Exposure Prevention Being Studied Source: Rebecca Sladek Nowlis, News Services |
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