Post-exposure HIV drugs won't boost risky behavior

Post-exposure HIV drugs won't boost risky behavior
NEW YORK (Reuters Health) - Giving antiretroviral drugs topeople after they may have been exposed to HIV is an effectiveway to prevent them from contracting the virus, a new studyshows.
What's more, people who know this option is available tothem don't appear to be more likely to engage in riskybehavior, Dr. Steve Shoptaw of the UCLA Department of FamilyMedicine in Los Angeles, who was involved in the research, toldReuters Health. "This is a viable way of helping people stay(HIV)-negative," he said.
So-called post-exposure prophylaxis, or PEP, has long beenavailable to people who risk HIV infection on the job, forexample a health care worker accidentally jabbed by acontaminated syringe. In 2005, the Centers for Disease Controland Prevention expanded its PEP guidelines to cover peopleexposed to HIV outside the workplace, for example through riskysex, condom breakage or drug use. But PEP still isn't widelyused in such cases, Shoptaw and his team note, because it isn'tcovered by health insurance and is only very rarely offered aspart of community health programs.
To investigate the feasibility of a community organized andfunded non-occupational PEP program, the researchers conducteda demonstration project in which people were offered a 28-daycourse of anti-HIV drugs within 72 hours of potential exposureto HIV.
One hundred people, 95 of them men, participated. Theyreceived the drug treatment, HIV testing, and counseling for upto 26 weeks after enrolling in the study. Fifty-eightparticipants reported having unprotected anal sex, while 18percent reported condom breakage.
Among the 84 people given the full course of medication, 75percent actually took all the drugs. No one became HIV-positiveduring the course of the study.
Some health authorities have been reluctant to offer PEPafter risky sex or drug use for fear that people wouldn'tchange their behavior if they knew "there's a parachutesomewhere they can take to stay negative," Shoptaw noted.However, he and his colleagues found people reduced their riskbehavior after using PEP, rather than increasing it.
He and his colleagues call for making non-occupational PEPprograms more widely available to people at high risk ofbecoming infected with HIV. For now, Shoptaw noted, PEP isavailable only to people who can access it and pay for it outof 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.