Abstract
ObjectiveWe aimed to determine the trends in numbers and percentages of sexually exposed persons to HIV (SE) consulting an ED for post-exposure prophylaxis (PEP), as well as predictors of condom use.Study DesignWe conducted a prospective-observational study.MethodsWe included all SE attendances in our Emergency Department (ED) during a seven-year study-period (2006–2012). Trends were analyzed using time-series analysis. Logistic Regression was used to define indicators of condom use.ResultsWe enrolled 1851 SE: 45.7% reported intercourse without condom-use and 12.2% with an HIV-infected partner. Significant (p<0.01) rising trends were observed in the overall number of SE visits (+75%), notably among men having sex with men (MSM) (+126%). There were rising trends in the number and percentage of those reporting intercourse without condom-use in the entire population +91% (p<0.001) and +1% (p>0.05), in MSM +228% (p<0.001) and +49% (p<0.001), in Heterosexuals +68% (p<0.001) and +10% (p = 0.08). Among MSM, significant rising trends were found in those reporting high-risk behaviours: anal receptive (+450% and +76%) and anal insertive (+l33% and +70%) intercourses. In a multivariate logistic regression analysis, heterosexuals, vaginal intercourse, visit during the night-shift and short time delay between SE and ED visit, were significantly associated with condom-use.ConclusionWe report an increasing trend in the number of SE, mainly among MSM, and rising trends in high-risk behaviours and unprotected sexual intercourses among MSM. Our results indicate that SE should be considered as a high-risk population for HIV and sexually transmitted diseases.
Highlights
Post-exposure prophylaxis (PEP) has been recommended around the world to prevent HIV infection following a high risk sexual encounter [1,2]
When we established the factors associated with condom use, we found on a multivariate analysis that men having sex with men (MSM) use condoms less frequently than heterosexuals and that anal intercourse is less frequently associated with condom use compared to vaginal intercourse
Our results indicate an increase in the number of attendances after sexual exposure to HIV among MSM, but above all an increase of the number and the percentage of HIV high-risk transmission intercourses and unprotected intercourses among MSM
Summary
Post-exposure prophylaxis (PEP) has been recommended around the world to prevent HIV infection following a high risk sexual encounter [1,2]. Surveys on sexual behaviour and condom use have focused on sexual and preventive practices among the general population [6] and men having sex with men (MSM) [7], some of them reporting a substantial increase in condom use before 2000 [8]. In France, a repeated survey across the general population indicates that the proportion of individuals reporting condom use at their most recent intercourse in 2010 is at its lowest reported level during an 18 year follow-up period [6]. No study has described, among sexually exposed patients to HIV, their behaviours and condom use
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