Prescription of HIV Post-Exposure Prophylaxis in emergency care units and return for follow-up appointments in specialized services in Salvador, Brazil, 2018: a cross-sectional study

Prescripción de Profilaxis Post Exposición al VIH en unidades de emergencia y consulta de control en unidades de seguimiento y de acompañamiento, Salvador, 2018: un estudio transversal

Abstract

Objective:

To analyze HIV Post-Exposure Prophylaxis (PEP) prescription and return for follow-up appointments.

Methods:

This was a descriptive cross-sectional study using data on people who sought PEP in emergency care units (UPAs) and specialized medical services in Salvador, BA, Brazil, between January-December/2018.

Results:

Of the 1,525 people who sought PEP at UPAs, 1,273 (83.5%) met PEP eligibility criteria, while 252 (16.5%) did not; of the eligible group, 1,166 (91.6%) had antiretrovirals prescribed, while 107 (8.4%) eligible people did not; of the total number of people with PEP prescriptions, only 226 (19.4%) returned for the first follow-up appointment, 115 (9.9%) for the second, and 33 (2.8%) for the third in order to complete the protocol.

Conclusion:

We found a significant proportion of eligible users who did not have PEP prescribed at UPAs and a significant loss of return for specialized service follow-up appointments.

Keywords:
HIV; Post-Exposure Prophylaxis; Disease Prevention; Access to Essential Medicines and Technologies; Continuity of Patient Care; Cross-Sectional Studies

Study contributions

Main results

Of those eligible for post-exposure prophylaxis (PEP), 8.4% did not receive it in emergency care units (UPAs); of those who did receive it, only 19.4% returned for the 1^st appointment, 9.9% for the 2^nd appointment and 2.8% for the 3^rd appointment in order to complete the protocol.

Implications for services

Training and discussion of the implementation of initial prescription of PEP at UPAs and its subsequent monitoring in centers specialized in the human immunodeficiency virus (HIV) must be promoted; percentage adherence to follow-up was low.

Perspectives

Expansion of continuing education actions for UPA professionals to ensure timely PEP prescription, in addition to the creation of strategies to link PEP users to follow-up appointments in health services.