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Active recalling increases follow up attendance rates for men having sex with men (msm) prescribed non occupational post exposure prophylaxis (npep). A 2 ½ year prospective review.

Active recalling increases follow up attendance rates for men having sex with men (msm) prescribed non occupational post exposure prophylaxis (npep). A 2 ½ year prospective review.

Studies have shown that attendance rates of patients for review following NPEP, particularly at the three and six month intervals are not satisfactory. The follow-up of patients taking NPEP is important for the following reasons: 1. To increase compliance rates of NPEP regime completion 2. Ensure HIV seroconversion has not occurred 3. Allow regular STI screening in at risk patients 4. Reinforce education / behavioural counselling to decrease future high risk behaviours.

A pilot study we conducted of 13 patients receiving NPEP showed significant improvement in follow up attendance rates with active recalling. As a result this has become standard practice at our institution and we now present prospective data of MSM attendance for NPEP over the last 2 ½ years. Patients attending for NPEP are actively recalled by the clinic nurse/counsellor via phone call, sms or email to remind them of their upcoming appointment. Follow up attendance rates were prospectively collected and medical files reviewed for evidence of changes in high risk behaviour on subsequent visits.

A total of 52 MSM patients attended our institution for NPEP between September 2010 and February 2013. 44% of the study cohort was aged less than 25 years. 5 were excluded from analysis as they continued their management at another clinic. Of the remaining 47 patients; • 36/47 (76.6%) attended their 3 month appointment (compared to previously reported rates of 30-51% ) • 32/47 (68%) attended their 6 month appointment (compared to previously reported rates of 20% ) Of the 11 patients who did not attend their 3-month appointment, 6 still completed NPEP treatment. 23/47 patients (49%) reported new risk reduction behaviour on subsequent visits. 3 patients later acquired HIV though in all these cases it was unrelated to the initial risk behaviour incident for which NPEP was administered.

This follow up study suggests active recalling increases subsequent clinic attendance post NPEP, providing opportunity for essential STI screening / monitoring, education and further risk reduction counselling. A large proportion 23/47 (49%) reported risk reduction behaviour following this practice.

Speakers: Sharon Doughty

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