The structure and outcomes of a hiv postexposure prophylaxis program in a high hiv prevalence setup in Western Kenya

Abraham M. Siika, Winston M. Nyandiko, Ann Mwangi, Michael Waxman, John E. Sidle, Sylvester N. Kimaiyo, Kara Wools-Kaloustian

Research output: Contribution to journalArticle

25 Scopus citations

Abstract

BACKGROUND: In 2001, HIV postexposure prophylaxis (PEP) was initiated in western Kenya. METHODS: Design, implementation, and evolution of the PEP program are described. Patient data were analyzed for reasons, time to initiation, and PEP outcome. RESULTS: Occupational PEP was initiated first followed by nonoccupational PEP (nPEP). Antiretroviral regimens were based upon national PEP guidelines, affordability and availability, and prevailing HIV prevalence. Emerging side effects data and cost improvements influenced regimen changes. Between November 2001 and December 2006, 446 patients sought PEP. Occupational exposure: 91 patients: 51 males; 72 accepted HIV testing; 48 of 52 source patients were HIV infected; median exposure-PEP time 3 hours (range: 0.3-96 hours). Of 72 HIV-negative patients receiving PEP, 3 discontinued, 69 completed, and 23 performed post-PEP HIV RNA polymerase chain reaction (all negative). Eleven follow-up HIV enzyme-linked immunosorbent assay tests have all turned negative. Nonoccupational exposure: 355 patients; 285 females; 90 children; 300 accepted HIV testing; median exposure-nPEP time 19 hours (range: 1-672 hours). Of 296 HIV-negative patients on nPEP, 1 died, 15 discontinued, 104 are on record having completed PEP, and 129 returned for 6-week HIV RNA polymerase chain reaction (1 patient tested positive). Eighty-seven follow-up HIV enzyme-linked immunosorbent assay tests have all turned negative. CONCLUSIONS: It is feasible to provide PEP and nPEP in resource-constrained settings.

Original languageEnglish (US)
Pages (from-to)47-53
Number of pages7
JournalJournal of Acquired Immune Deficiency Syndromes
Volume51
Issue number1
DOIs
StatePublished - May 1 2009

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Keywords

  • Health care worker
  • HIV
  • Postexposure prophylaxis
  • Sexual assault

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

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