Presentation on theme: "Experience of a NYC hospital with non- occupational post-exposure prophylaxis (nPEP) Antonio Urbina 1, Georgina Osorio 1, Daniel Egan 2, Paul Galatowitsch."— Presentation transcript:
Experience of a NYC hospital with non- occupational post-exposure prophylaxis (nPEP) Antonio Urbina 1, Georgina Osorio 1, Daniel Egan 2, Paul Galatowitsch 3, Benjamen Riggan 1 ; Zachariah Hennessey 1 ; Victoria Sharp Center for Comprehensive Care, St. Luke’s-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY, USA 1 ; St. Luke’s-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY, USA 2 ; Health Clear Strategies, New York, NY, USA 3 Oral Abstract TUPDC0305 XIX International AIDS Conference Washington, DC, USA July 24, 2012
SLR has provided nPEP in its 2 EDs and 3 outpatient HIV clinics (CCC) Retrospective chart review of adult patients who received nPEP from 12/2009 to 2/2012 Demographics of patients who undertook nPEP and completed follow-up were compared Figure 1. Flow diagram of nPEP protocol Patient presents to SLRH ED or CCC within 72 hours of exposure to potentially HIV- infected fluid. Baseline HIV rapid antibody testing performed with surveillance labs. In ED, patient provided 4-day supply of nPEP with follow-up appointment to CCC outpatient HIV clinic Patient presents for follow-up. Provided prescription (insured) or supply of nPEP (grant funded) to complete 28 days of treatment 2-, 4-, and 12-week follow-up. Background/Methods
Results Table 1. Baseline characteristics of patients 116/138 (84%) of patients referred to CCC completed 4-week f/u No significant differences seen for patients who completed nPEP One patient sero-converted after initiating nPEP 32 hours post exposure CharacteristicAll Patients (N=216) Patients linked to care & completed 28-day nPEP (N=116) Mean Age – yr (range)29.5 (18-62)30 (18-62) Male - no. (%)180 (83%)92 (84%) Race/ethnicity - no. (%) Non-Hispanic white99 (46%)49 (42%) Risk of HIV exposure – no. (%) men who have sex with men139 (64%)74 (68%) Hours from HIV exposure to presentation – hours (range) 25 (1-74)26 (1-74)
Conclusions nPEP is a chemo-prophylaxis intervention that can prevent HIV acquisition and transmission and provides additional opportunities for synergistic biological and behavioral interventions. A multi-disciplinary approach is necessary to coordinate care, follow-up, and supportive counseling leading to successful linkage to care and completion of 28-day nPEP. Funding: This work was supported by grants from the New York City Department of Health and Mental Hygiene and the New York State Department of Health AIDS Institute.