HIV NON-OCCUPATIONAL POST-EXPOSURE PROPHYLAXIS IN UKRAINE
DOI:
https://doi.org/10.32782/2077-6594.4.0.2020.220374Keywords:
HIV/AIDS, post-exposure prophylaxis, non-occupational contactsAbstract
Aim. To assess the state of non-occupational HIV post exposure prophylaxis (nPEP) use in Ukraine through exploring the service delivery algorithm, consumption of service, awareness of beneficiaries.
Methods. The research has explorative and qualitative design. In-depth semi-structural interviews with experts were conducted. For recruitment snowball sampling technique is used. Geography of the study is Kyiv, Ukraine.
Results. Legislative framework of nPEP is established in Ukraine. NPEP is provided in specialized medical facilities with continuous access to the prevention. In order to increase effectiveness in nPEP delivery particular stages of nPEP complex have potential for improvement. Risky sexual behavior and contacts with used syringe or needle are the most common reasons to apply for nPEP. Applications for nPEP include emergency single contacts and cases of multiple appeals from the same persons. Prevention strategy nPEP may be underutilized and require further examination. Awareness of nPEP is considered to be low or insufficient in beneficiaries.
Conclusions. 1) It is recommended to analyze the best practices of nPEP delivery and design/adapt supplementary tools in order to increase effectiveness in service delivery. 2) Prevention strategy nPEP may be underutilized. Utilization and potential beneficiaries of nPEP are the directions for further study. For the nPEP adequate targeting purpose, the linkage between nPEP and PreP prevention strategies ought to be established. 3) Low awareness of nPEP and its factors is the topic for further examination.
References
UNAIDS. Global AIDS Monitoring 2018: Ukraine. UNAIDS. 2018. Available from: https://www.unaids.org/sites/ default/files/country/documents/UKR_2018_countryreport.pdf.
HIV-infection in Ukraine. Informational bulletin №50. 2019. Available from: https://phc.org.ua/kontrol-zakhvoryuvan/vilsnid/monitoring-i-ocinka/informaciyni-byuleteni-vilsnid.
HIV-infection in Ukraine. Informational bulletin №48. 2017. Available from: https://phc.org.ua/kontrol-zakhvoryuvan/vilsnid/monitoring-i-ocinka/informaciyni-byuleteni-vilsnid.
Public Health Center of the MOH of Ukraine. Information on HIV post-exposure prophylaxis. 2016. Available from: https://phc.org.ua/vilsnid/statistika/postkontaktna-profilaktika-pkp.
Public Health Center of the MOH of Ukraine. Information on HIV post-exposure prophylaxis (report). 2016. Available from: https://phc.org.ua/sites/default/files/uploads/documents/files/0194412b6fcc269b46a5996250dbc646.pdf.
Public Health Center of the MOH of Ukraine. Information on HIV post-exposure prophylaxis. 2017. Available from: https://phc.org.ua/sites/default/files/uploads/documents/files/9691ca9687e93d8a4345245f296ff12c.pdf.
Nakaz Ministerstva Okhorony Zdorovia Ukrainy vid 22.05.2013 №410. Pro Zatverdzhennia Form Oblikovoi Dokumentatsii Ta Zvitnosti Stosovno Reiestratsii Vypadkiv Kontaktu Osib Z Kroviu Chy Biolohichnymy Materialamy Liudyny Zabrudnenymy Nymy Instrumentariiem Obladnanniam Chy Predmetamy Provedennia Postkontaktnoi Profilaktyky VIL-Infektsii Ta Instruktsii Shchodo Yikh Zapovnennia. Available from: https://zakon.rada.gov.ua/laws/show/z0902-13.
CDC. Updated Guidelines for Antiretroviral Postexposure Prophylaxis After Sexual, Injection Drug Use, or Other Nonoccupational Exposure to HIV, 2016. Available at: https://www.cdc.gov/hiv/pdf/programresources/cdc-hiv-npep-guidelines.pdf.
Nakaz Ministerstva Okhorony Zdorovia Ukrainy vid 05.11.2013 №955. Poriadok Provedennia Ekstrenoi Postkontaktnoi Profilaktyky VIL-Infektsii u Pratsivnykiv pry Vykonanni Profesiinykh Oboviazkiv. Available at: https://zakon.rada.gov.ua/laws/show/z1980-13#n4.
Rodríguez AE, Castel AD, Parish CL, Willis S, Feaster DJ, Kharfen M, Cardenas GA, Villamizar K, Kolber M, Vázquez-Rivera L, Metsch LR. HIV medical providers' perceptions of the use of antiretroviral therapy as nonoccupational postexposure prophylaxis in 2 major metropolitan areas. J Acquir Immune Defic Syndr. 2013 Nov 1;64 Suppl 1(0 1):S68-79. doi: 10.1097/QAI.0b013e3182a901a2. PMID: 24126450; PMCID: PMC3845443.
Malinverni S, Libois A, Gennotte AF, La Morté C, Mols P. Prescription of Non-Occupational Post-Exposure HIV Prophylaxis by Emergency Physicians: An Analysis on Accuracy of Prescription and Compliance. PLoS One. 2016 Apr 12;11(4):e0153021. doi: 10.1371/journal.pone.0153021. PMID: 27070319; PMCID: PMC4829160.
McDougal SJ, Alexander J, Dhanireddy S, Harrington RD, Stekler JD. Non-occupational post-exposure prophylaxis for HIV: 10-year retrospective analysis in Seattle, Washington. PLoS One. 2014 Aug 20;9(8):e105030. doi: 10.1371/ journal.pone.0105030. PMID: 25140868; PMCID: PMC4139302.
Teo AKJ, Tai BC, Chio MT, La HH. A mixed methods study of non-occupational post-exposure prophylaxis at an STI clinic in Singapore: Five-year retrospective analysis and providers' perspectives. PLoS One. 2018 Aug 20;13(8):e0202267. doi: 10.1371/journal.pone.0202267. PMID: 30125333; PMCID: PMC6101390.
Poynten IM, Smith DE, Cooper DA, Kaldor JM, Grulich AE. The public health impact of widespread availability of nonoccupational postexposure prophylaxis against HIV. HIV Med. 2007 Sep;8(6):374-81. doi: 10.1111/j.1468-1293.2007.00483.x. PMID: 17661845.
World Health Organization. Post-exposure prophylaxis to prevent HIV infection: joint WHO/ILO guidelines on post-exposure prophylaxis (PEP) to prevent HIV infection. 2007. Available at: https://www.who.int/hiv/pub/prophylaxis/ pep_guidelines/en.
World health organization. Guidelines on post-exposure prophylaxis for hiv and the use of co-trimoxazole prophylaxis for hiv-related infections among adults, adolescents and children. Recommendations for a public health approach. 2014. Available at: https://www.who.int/hiv/pub/guidelines/arv2013/arvs2013upplement_dec2014/en.
CMAJ. Canadian guideline on HIV pre-exposure prophylaxis and nonoccupational postexposure prophylaxis. 2017. Available from: doi: 10.1503/cmaj.170494.
BASHH. UK Guideline for the use of HIV Post-Exposure Prophylaxis Following Sexual Exposure (PEPSE). 2015. Available from: https://www.bashh.org/documents/PEPSE%202015%20guideline%20final_NICE.pdf.
Ford N, Irvine C, Shubber Z, Baggaley R, Beanland R, Vitoria M, Doherty M, Mills EJ, Calmy A. Adherence to HIV postexposure prophylaxis: a systematic review and meta-analysis. AIDS. 2014 Nov 28;28(18):2721-7. doi: 10.1097/QAD.0000000000000505. PMID: 25493598.
Thomas R, Galanakis C, Vézina S, Longpré D, Boissonnault M, Huchet E, Charest L, Murphy D, Trottier B, Machouf N. Adherence to Post-Exposure Prophylaxis (PEP) and Incidence of HIV Seroconversion in a Major North American Cohort. PLoS One. 2015 Nov 11;10(11):e0142534. doi: 10.1371/journal.pone.0142534. PMID: 26559816; PMCID: PMC4641668.
Iloanusi SH, Mgbere OO, Abughosh SM, Essien EJ. HIV Non-Occupational Post Exposure Prophylaxis in Nigeria: A Systematic Review of Research Evidence and Practice. Int J MCH AIDS. 2019;8(2):101-119. doi: 10.21106/ijma.287. Epub 2019 Nov 18. PMID: 31803532; PMCID: PMC6886157.
Wang Z, Yuan T, Fan S, Qian HZ, Li P, Zhan Y, Li H, Zou H. HIV Nonoccupational Postexposure Prophylaxis Among Men Who Have Sex with Men: A Systematic Review and Meta-Analysis of Global Data. AIDS Patient Care STDS. 2020 May;34(5):193-204. doi: 10.1089/apc.2019.0313. PMID: 32396477.
Feng M, Yu C, Liang Z, People seeking sexually transmitted diseases screening, medical professionals, and members of the general public surveyed regarding knowledge about non-occupational post-exposure prophylaxis for HIV. Sexually Transmitted Infections. 2015; 91(2). Available from: https://sti.bmj.com/content/91/Suppl_2/A245.1.abstract.
Ajayi AI, Ismail KO, Adeniyi OV, Akpan W. Awareness and use of pre-exposure and postexposure prophylaxes among Nigerian university students: Findings from a cross-sectional survey. Medicine (Baltimore). 2018 Sep;97(36):e12226. doi: 10.1097/MD.0000000000012226. PMID: 30200145; PMCID: PMC6133481.
Chomchey N, Woratanarat T, Hiransuthikul N, Lertmaharit S, Lohsoonthorn V, Teeratakulpisarn N, Pinyakorn S, Fletcher JL, Suttichom D, Phanuphak P, Ananworanich J, Phanuphak N. Factors associated with intention to take non-occupational HIV post-exposure prophylaxis among Thai men who have sex with men. J Virus Erad. 2017 Jul 1;3(3):128-139. PMID: 28758020; PMCID: PMC5518241.
Martinez O, Wu E, Levine EC, Muñoz-Laboy M, Fernandez MI, Bass SB, Moya EM, Frasca T, Chavez-Baray S, Icard LD, Ovejero H, Carballo-Diéguez A, Rhodes SD. Integration of Social, Cultural, and Biomedical Strategies into an Existing Couple-Based Behavioral HIV/STI Prevention Intervention: Voices of Latino Male Couples. PLoS One. 2016 Mar 30;11(3):e0152361. doi: 10.1371/journal.pone.0152361. PMID: 27028873; PMCID: PMC4814093.
Lin SY, Lachowsky NJ, Hull M, Rich A, Cui Z, Sereda P, Jollimore J, Stephenson K, Thumath M, Montaner J, Roth EA, Hogg RS, Moore DM. Awareness and use of nonoccupational post-exposure prophylaxis among men who have sex with men in Vancouver, Canada. HIV Med. 2016 Oct;17(9):662-73. doi: 10.1111/hiv.12369. Epub 2016 Aug 1. PMID: 27477994; PMCID: PMC5207792.
Koblin BA, Usher D, Nandi V, Tieu HV, Bravo E, Lucy D, Miles L, Ortiz G, Kindlon MJ, Parisi DM, Frye V. Post-exposure Prophylaxis Awareness, Knowledge, Access and Use Among Three Populations in New York City, 2016-17. AIDS Behav. 2018 Aug;22(8):2718-2732. doi: 10.1007/s10461-018-2175-5. PMID: 29858737.
Lebona M.A. Assessment of knowledge, attitudes and utilisation of HIV post-exposure prophylaxis among adults, Roma, Lesotho. University of South Africa, Pretoria. 2016. Available from: http://hdl.handle.net/10500/22535.
ICF “Alliance for Public Health”. Statystyka. Available from: http://aph.org.ua/uk/resursy/statystyka.
CO “100%Life”. Proekty. Available from: http://network.org.ua/ru/proekty-2.
Public Health Center of the MOH of Ukraine. Natsionalna strategia testuvannia na VIL v Ukraini 2019–2030. 2018. Available from: https://phc.org.ua/sites/default/files/uploads/files/Natsionalna_strategia_testuvannia_na_VIL_v_Ukraini_2019-2030.pdf.
