The Characteristics of Men Who Have Sex With Men (MSM) Using Post-Exposure Prophylaxis for Sexual Exposure (PEPSE) in the Pre-Exposure Prophylaxis (PrEP) Era

Daniel Richardson; Kayleigh Nichols; Richard Hughes; Hannah Smith; Colin Fitzpatrick; Fiona Cresswell

Disclosures

HIV Medicine. 2022;23(5):553-557. 

In This Article

Results

Overall, 126 MSM used PEPSE in a 6-month period in 2017 and 28 MSM used PEPSE in 2017, representing a 78% reduction in MSM using PEPSE. None of the MSM had previously used PEPSE or PrEP before and had not attended and declined PEPSE or PrEP in the past. Those MSM using PEPSE in 2021 were significantly younger [27 years, interquartile range (IQR): 24–34] compared with the 2017 group (35 years, IQR: 28–46; p < 0.01). When compared with 2017, MSM using PEPSE in 2021 were significantly more likely to identify as from a black or minority ethnic group [29% (8/28) vs. 8% (10/126); p < 0.01]; to attend as a result of a group sex encounter [35% (10/28) vs. 16% (10/126); p = 0.03]; to attend following sex involving recreational drug use [32% (9/28) vs. 13% (16/126); p = 0.02]; and to initiate PEPSE in the emergency department [35% (10/28) vs. 19% (24/126); p = 0.04]. MSM attending for PEPSE in 2021 were significantly less likely to attend for at least one follow-up appointment compared with MSM in 2017 [71% (20/28) vs. 87% (110/126); p < 0.05]. There were no differences in the proportion of transgender people using PEPSE [1 (4%) vs. 3 (2%); p = 0.56], MSM using PEPSE following a sexual assault [(0 vs. 12 (10%); p = 0.13], MSM using PEPSE following an encounter with a non-steady sexual partner [26 (93%) vs. 124 (98%); p = 0.15] or completion of PEPSE [19 (68%) vs. 101 (80%); p = 0.21] when comparing MSM using PEPSE in 2021 versus 2017. (Table 1) There were no HIV seroconversions in MSM who attended follow-up after PEPSE in 2017 (n = 110) or 2021 (n = 20). Of the MSM who used PEPSE in 2021, all 20 were appropriately offered PrEP and 19/20 (95%) transitioned immediately to PrEP.

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