PRE-EXPOSURE PROPHYLAXIS (PREP) OF HIV INFECTION – A CRUCIAL TOOL FOR REDUCING THE BURDEN UPON THE PUBLIC HEALTH

Abstract

HIV is a major global public health problem.The increased access to effective prevention, diagnosis and treatment transformed HIV-infection intoa manageable chronic health condition.Our purpose was to assess the effectiveness of oral pre-exposure prophylaxis (PrEP) of HIV-infection. Material and Methods: CheckPoint Sofia (former Sexual Health Centre – Sofia) is a medical center for consultations, prevention, diagnosis and treatment of sexually transmitted infections (STI’s) and HIV/AIDS. A retrospective study was conducted on 410 consulted males (HIV-seronegative) (October 2020 to August 2022). Results: The mean age was 32±7.6 years (18-57 years) with prevalent ages <30 and 30-40 years (42% and 47%, respectively); Bulgarian citizens 90%, MSM (97%). The clients’ profile revealed active sporting (38%), past STI’s (26%), vaccinated for HBV (54%). No one of the subjects had chronic kidney disease and mandatory investigations of renal functions at starting of PrEP revealed mean levels of urea and creatinine 4.9±1.42 mmol/L and 78±18.2 µmol/L, respectively. On demand regimen (2+1+1 tablets) of PrEP was preferred at 91% and 15% switched to everyday receiving before an increased risk. After starting of PrEP, 55% of the subjects were tested voluntary and no one was positive for HIV, HBV, and HCV. The once reported side effect was transitory diarrhea (in 5%) after the start of PrEP. It is notable that the increased STI’s (syphilis, chlamydia and gonorrhea – 10%, 6% and 5%, respectively) – fact in accordance with global trends. Conclusion: PrEP is an effective prevention of HIV infectionand deserves budgetary finance. The increase of STI’s requires concrete preventive implementations.