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Predictors of Standard Follow-Up Completion after Sexual Exposure to HIV: Five-Year Retrospective Analysis in a French HIV-Infection Care Center.
Gantner, Pierre; Treger, Michele; De Miscault, Constance; Batard, Marie-Laure; Bernard-Henry, Claudine; Cheneau, Christine; De Mautort, Erik; Partisani, Marialuisa; Priester, Michele; Rey, David.
Afiliación
  • Gantner P; Le Trait d'Union, HIV-infection care center, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
  • Treger M; Biostatistics Laboratory, Faculté de Médecine, Université de Strasbourg, Strasbourg, France.
  • De Miscault C; Le Trait d'Union, HIV-infection care center, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
  • Batard ML; Le Trait d'Union, HIV-infection care center, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
  • Bernard-Henry C; Le Trait d'Union, HIV-infection care center, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
  • Cheneau C; Le Trait d'Union, HIV-infection care center, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
  • De Mautort E; Le Trait d'Union, HIV-infection care center, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
  • Partisani M; Le Trait d'Union, HIV-infection care center, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
  • Priester M; Le Trait d'Union, HIV-infection care center, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
  • Rey D; Le Trait d'Union, HIV-infection care center, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
PLoS One ; 10(12): e0145440, 2015.
Article en En | MEDLINE | ID: mdl-26696009
OBJECTIVES: The care of exposed individuals to HIV remains a challenge regarding follow-up completion and HIV-testing of the partner. Identifying patients with risk of not fulfilling HIV-testing follow-up completion (FC), among patients demanding non-occupational post-exposure prophylaxis (nPEP), may improve clinical practice. METHODS: A retrospective chart review was conducted in a single French HIV-infection care center. FC predictors were assessed in a multivariate logistic regression model (Likelihood ratios test). RESULTS: Between 2009 and 2013, 646 sexual exposures to HIV were evaluated for nPEP, of which 507 effectively received nPEP (78%). FC rate was 30% (194/646). In the multivariate analysis, FC rates rose with age of exposed individuals (OR, 1.04 [0.25-4.28]; p<0.001) and decreased with the year of sexual exposure (OR, 0.74 [0.65-0.85]; p<0.001). FC was associated with sexual encounter with a sex worker (OR, 4.07 [0.98-16.82]; p<0.001) and nPEP use (OR, 2.69 [2.37-3.06]; p<0.001). nPEP early discontinuation was associated with decreased FC rates (OR, 0.18 [0.08-0.39]; p<0.001). No documented nPEP failure was identified. However, five Men who have Sex with Men (MSM) nPEP recipients for unprotected anal receptive intercourse subsequently seroconverted to HIV more than 6 months after nPEP. Seroconversion to HIV was associated with the lack of FC (p = 0.04) and multiple presentations for nPEP over the study period (p = 0.002). CONCLUSIONS: We identified significant predictors of not fulfilling sequential HIV-testing. They appear to be linked with a self-perceived HIV risk, especially in young adults recently exposed. Enhanced counseling in targeted individuals with high risk behaviors and using smartphone and internet-based strategies may be interesting retention in care options.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Profilaxis Posexposición Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male País/Región como asunto: Europa Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2015 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Profilaxis Posexposición Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male País/Región como asunto: Europa Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2015 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Estados Unidos