Post-exposure HIV drugs won't boost risky behavior

Fri Nov 23, 2007 4:28 PM GMT

By Anne Harding

NEW YORK (Reuters Health) - Giving antiretroviral drugs to people after they may have been exposed to HIV is an effective way to prevent them from contracting the virus, a new study shows.

What's more, people who know this option is available to them don't appear to be more likely to engage in risky behavior, Dr. Steve Shoptaw of the UCLA Department of Family Medicine in Los Angeles, who was involved in the research, told Reuters Health. "This is a viable way of helping people stay (HIV)-negative," he said.

So-called post-exposure prophylaxis, or PEP, has long been available to people who risk HIV infection on the job, for example a health care worker accidentally jabbed by a contaminated syringe. In 2005, the Centers for Disease Control and Prevention expanded its PEP guidelines to cover people exposed to HIV outside the workplace, for example through risky sex, condom breakage or drug use. But PEP still isn't widely used in such cases, Shoptaw and his team note, because it isn't covered by health insurance and is only very rarely offered as part of community health programs.

To investigate the feasibility of a community organized and funded non-occupational PEP program, the researchers conducted a demonstration project in which people were offered a 28-day course of anti-HIV drugs within 72 hours of potential exposure to HIV.

One hundred people, 95 of them men, participated. They received the drug treatment, HIV testing, and counseling for up to 26 weeks after enrolling in the study. Fifty-eight participants reported having unprotected anal sex, while 18 percent reported condom breakage.

Among the 84 people given the full course of medication, 75 percent actually took all the drugs. No one became HIV-positive during the course of the study.

Some health authorities have been reluctant to offer PEP after risky sex or drug use for fear that people wouldn't change their behavior if they knew "there's a parachute somewhere they can take to stay negative," Shoptaw noted. However, he and his colleagues found people reduced their risk behavior after using PEP, rather than increasing it.

He and his colleagues call for making non-occupational PEP programs more widely available to people at high risk of becoming infected with HIV. For now, Shoptaw noted, PEP is available only to people who can access it and pay for it out of pocket -- drugs and counseling together cost about $2,200.

Right now, "this is more of a social justice issue," Shoptaw said. "People who have means have access to this, people who don't, don't."

SOURCE: AIDS Care, published online October 24, 2007.

Sex diseases rising among young in the UK

Sat Nov 24, 2007 12:08 AM GMT

LONDON (Reuters) - About 73,000 people in Britain are living with HIV, with a "continuing epidemic" among gay men, as the number of sexually transmitted diseases among the young continues to rise, a report on Friday found.

The Health Protection Agency's survey on sexual health said the number of new diagnosed STIs (sexually transmitted infections) had risen from 368,341 in 2005 to 376,508 last year, with people under 25 involved in many cases.

The report said that two-thirds of those diagnosed with genital chlamydia, 55 percent of those with genital warts and 48 percent of gonorrhoea infections had been young adults.

"Sexual health of young adults has worsened in 2006 with increases in sexually transmitted herpes and warts viruses," said Dr Valerie Delpech, head of HIV surveillance at the HPA.

"One in 10 young adults screened through the National Chlamydia Screening Programme in 2006 tested positive for the infection."

The HPA's greatest concern was the growth in HIV cases. Figures showed 7,093 people had so far been diagnosed with the disease in 2006, a number expected to rise to around 7,800 when they had received all data..

"We are still seeing high levels of HIV transmission in gay men in whom we anticipate that there will have been just over 2,700 new diagnoses of HIV infection in 2006," Delpech said.

The HPA now estimates that about 73,000 in the country now have HIV, with about a third (21,600) unaware of their HIV status.

Professor Pete Borriello, director of the HPA's Centre for Infections, said control of HIV and STIs was a major challenge and that gay men should have regular HIV tests.

"We need to reinforce the safe sex message for gay men, young adults and broader community," Borriello said.

(Reporting by Michael Holden; editing by Peter Griffiths)