Nonoccupational Post-Exposure Prophylaxis for HIV in New York State Emergency Departments

• Published in: Journal of the International Association of Providers of AIDS Care 2014-11, Vol.13 (6), p.539-546
• Main Authors: Fitzpatrick, Laura J., Egan, Daniel J., Cowan, Ethan, Savitsky, Leah M., Kushner, John D., Calderon, Yvette, Agins, Bruce D.
• Format: Article
• Language: English
• Subjects: Anti-HIV Agents - therapeutic use; Antiretroviral drugs; Counseling; Directive Counseling; Emergency Service, Hospital; Guideline Adherence; Health Care Surveys; HIV; HIV Infections - diagnosis; HIV Infections - prevention & control; Hospitals; Human immunodeficiency virus; Humans; Mass Screening; New York; Patient Education as Topic; Patients; Post-Exposure Prophylaxis; Practice Guidelines as Topic; Risk Reduction Behavior; Sexually transmitted diseases; Sick role; STD; Symptoms; Tests; Veterans
• ISSN: 2325-9574; 2325-9582; 2325-9582
• DOI: 10.1177/2325957414553847

New York State (NYS) established guidelines for nonoccupational post-exposure prophylaxis (nPEP) to HIV in 1997. To assess current nPEP practices in NYS Emergency Departments (EDs), we electronically surveyed all ED directors in NYS, excluding Veterans’ Affairs hospitals, about nPEP and linkage-to-care protocols in the EDs. Basic descriptive statistics were used for analysis. The response rate was 96% (184/191). Of respondents, 88% reported evaluating any patient with a possible nonoccupational exposure to HIV, in accordance with NYS guidelines. Of these, 83% provided the patient with a starter pack of medications, while 4% neither supplied nor prescribed antiretroviral drugs in the ED. Sexually transmitted infection screening, risk reduction counseling, and education about symptoms of acute HIV seroconversion were performed inconsistently, despite NYS guidelines recommendations. Only 22% of EDs confirmed whether linkage to follow-up care was successful. Most NYS EDs prescribe nPEP to appropriate patients but full implementation of guidelines remains incomplete.