Nonoccupational post-exposure prophylaxis for HIV after sexual intercourse among women in Brazil: risk profiles and predictors of loss to follow-up

Detalhes bibliográficos
Autor(a) principal: Grangeiro, Alexandre
Data de Publicação: 2019
Outros Autores: Nascimento, Maria Mônica Paulino do, Zucchi, Eliana Miura, Ferraz, Dulce Aurélia de Souza, Escuder, Maria Mercedes, Arruda, Érico, Lotufo, Denize, Munhoz, Rosemeire, Couto, Marcia Thereza
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/43451
Resumo: Fundação Faculdade de Medicina e Ministério da Saúde
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spelling Grangeiro, AlexandreNascimento, Maria Mônica Paulino doZucchi, Eliana MiuraFerraz, Dulce Aurélia de SouzaEscuder, Maria MercedesArruda, ÉricoLotufo, DenizeMunhoz, RosemeireCouto, Marcia Thereza2020-09-18T16:08:12Z2020-09-18T16:08:12Z2019GRANGEIRO, Alexandre et al. Nonoccupational post-exposure prophylaxis for HIV after sexual intercourse among women in Brazil: risk profiles and predictors of loss to follow-up. Medicine, [Baltimore], v. 98, n. 39, p.1-9, 2019.0025-7974https://www.arca.fiocruz.br/handle/icict/4345110.1097/MD.0000000000017071Fundação Faculdade de Medicina e Ministério da SaúdeUniversidade de São Paulo. Faculdade de Medicina. São Paulo, SP, Brasil.Universidade Federal de Campina Grande. Cajazeiras, PB, Brasil.Universidade Católica de Santos. Programa de Pós-Graduação em Saúde Coletiva. Santos, SP, Brasil.Fundação Oswaldo Cruz. Fiocruz Brasília. Brasília, DF, Brasil.Governo de São Paulo. Secretaria de Estado de Saúde. Instituto de saúde. São Paulo, SP, Brasil.Universidade Estadual do Ceará. Faculdade de Medicina. Fortaleza, CE, Brasil / Universidade de Fortaleza. Fortaleza, CE, Brasil / Hospital São José de Doenças Infecciosas. Fortaleza, SP, Brasil.Governo de São Paulo. Secretaria de Estado de Saúde. Centro de Referência e Treinamento DST e Aids. São Paulo, SP, Brasil.Governo de São Paulo. Secretaria de Estado de Saúde. Centro de Referência e Treinamento DST e Aids. São Paulo, SP, Brasil.Universidade de São Paulo. Faculdade de Medicina. São Paulo, SP, Brasil.Access to antiretroviral-based HIV prevention has been marked by sex asymmetries, and its effectiveness has been compromised by low clinical follow-up rates. We investigated risk profiles of women who received nonoccupational post-exposure prophylaxis (nPEP), as well as the rates and predictive factors of loss to follow-up after nPEP initiation. Retrospective study evaluating 501 women who received nPEP between 2014 and 2015 at 5 HIV centers (testing centers-VCT, outpatient clinics, and infectious diseases hospital). Risk profiles were drawn based on the characteristics of the women and their sexual partners, and then stratified by sociodemographic indicators and previous use of HIV prevention services. Loss to follow-up (LTFU) was defined as not presenting for follow-up visits or for HIV testing after nPEP initiation. Predictors of LTFU were analyzed by calculating adjusted prevalence ratios (aPRs). Approximately 90% of women had sexual encounters that met the criteria established in the Brazilian guidelines for nPEP. Those who declared to be sex workers (26.5%) or drug users (19.2%) had the highest social vulnerability indicators. In contrast, women who had intercourse with casual partners of unknown HIV risk (42.7%) had higher education and less experience with previous HIV testing (89.3%) or nPEP use (98.6%). Of the women who received nPEP after sexual intercourse with stable partners, 75.8% had HIVinfected partners. LTFU rate was 72.8% and predictors included being Black (aPR=1.15, 95% confidence interval [CI]: 1.03–1.30), using drugs/alcohol (aPR=1.15, 95% CI: 1.01–1.32) and having received nPEP at an HIV outpatient clinic (aPR=1.35, 95% CI: 1.20–1.51) or at an infectious diseases hospital (aPR=1.37, 95% CI: 1.11–1.69) compared with a VCT. The risk of LTFU declined as age increased (aPR 41–59 years=0.80, 95% CI: 0.68–0.96). Most women who used nPEP had higher socioeconomic status and were not part of populations most affected by HIV. In contrast, factors that contribute to loss to follow-up were: having increased social vulnerability; increased vulnerability to HIV infection; and seeking nPEP at HIV treatment services as opposed to at a VCT. Abbreviations: aPRs = adjusted prevalence ratios, ART = antiretroviral therapy, HDI = Human Development Index, MSM = men who have sex with men, nPEP = nonoccupational post-exposure prophylaxis, PrEP = preexposure prophylaxis, VCT = HIV voluntary counseling and testing, Zres = standardized residual.porWillams & WilkinsAnti-Retroviral AgentsFollow-Up StudiesHIV InfectionsMedication AdherencePost-Exposure ProphylaxisRetrospective StudiesRisk-TakingSex WorkSocial ClassSubstance-Related DisordersUnsafe SexCombination preventionHIVPost-exposure prophylaxis after sexual exposureWomenAntirretroviraisSeguimentosInfecções por HIVAdesão à MedicaçãoProfilaxia Pós-ExposiçãoSexo sem ProteçãoNonoccupational post-exposure prophylaxis for HIV after sexual intercourse among women in Brazil: risk profiles and predictors of loss to follow-upinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ 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dc.title.pt_BR.fl_str_mv Nonoccupational post-exposure prophylaxis for HIV after sexual intercourse among women in Brazil: risk profiles and predictors of loss to follow-up
title Nonoccupational post-exposure prophylaxis for HIV after sexual intercourse among women in Brazil: risk profiles and predictors of loss to follow-up
spellingShingle Nonoccupational post-exposure prophylaxis for HIV after sexual intercourse among women in Brazil: risk profiles and predictors of loss to follow-up
Grangeiro, Alexandre
Anti-Retroviral Agents
Follow-Up Studies
HIV Infections
Medication Adherence
Post-Exposure Prophylaxis
Retrospective Studies
Risk-Taking
Sex Work
Social Class
Substance-Related Disorders
Unsafe Sex
Combination prevention
HIV
Post-exposure prophylaxis after sexual exposure
Women
Antirretrovirais
Seguimentos
Infecções por HIV
Adesão à Medicação
Profilaxia Pós-Exposição
Sexo sem Proteção
title_short Nonoccupational post-exposure prophylaxis for HIV after sexual intercourse among women in Brazil: risk profiles and predictors of loss to follow-up
title_full Nonoccupational post-exposure prophylaxis for HIV after sexual intercourse among women in Brazil: risk profiles and predictors of loss to follow-up
title_fullStr Nonoccupational post-exposure prophylaxis for HIV after sexual intercourse among women in Brazil: risk profiles and predictors of loss to follow-up
title_full_unstemmed Nonoccupational post-exposure prophylaxis for HIV after sexual intercourse among women in Brazil: risk profiles and predictors of loss to follow-up
title_sort Nonoccupational post-exposure prophylaxis for HIV after sexual intercourse among women in Brazil: risk profiles and predictors of loss to follow-up
author Grangeiro, Alexandre
author_facet Grangeiro, Alexandre
Nascimento, Maria Mônica Paulino do
Zucchi, Eliana Miura
Ferraz, Dulce Aurélia de Souza
Escuder, Maria Mercedes
Arruda, Érico
Lotufo, Denize
Munhoz, Rosemeire
Couto, Marcia Thereza
author_role author
author2 Nascimento, Maria Mônica Paulino do
Zucchi, Eliana Miura
Ferraz, Dulce Aurélia de Souza
Escuder, Maria Mercedes
Arruda, Érico
Lotufo, Denize
Munhoz, Rosemeire
Couto, Marcia Thereza
author2_role author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Grangeiro, Alexandre
Nascimento, Maria Mônica Paulino do
Zucchi, Eliana Miura
Ferraz, Dulce Aurélia de Souza
Escuder, Maria Mercedes
Arruda, Érico
Lotufo, Denize
Munhoz, Rosemeire
Couto, Marcia Thereza
dc.subject.mesh.pt_BR.fl_str_mv Anti-Retroviral Agents
Follow-Up Studies
HIV Infections
Medication Adherence
Post-Exposure Prophylaxis
Retrospective Studies
Risk-Taking
Sex Work
Social Class
Substance-Related Disorders
Unsafe Sex
topic Anti-Retroviral Agents
Follow-Up Studies
HIV Infections
Medication Adherence
Post-Exposure Prophylaxis
Retrospective Studies
Risk-Taking
Sex Work
Social Class
Substance-Related Disorders
Unsafe Sex
Combination prevention
HIV
Post-exposure prophylaxis after sexual exposure
Women
Antirretrovirais
Seguimentos
Infecções por HIV
Adesão à Medicação
Profilaxia Pós-Exposição
Sexo sem Proteção
dc.subject.en.pt_BR.fl_str_mv Combination prevention
HIV
Post-exposure prophylaxis after sexual exposure
Women
dc.subject.decs.pt_BR.fl_str_mv Antirretrovirais
Seguimentos
Infecções por HIV
Adesão à Medicação
Profilaxia Pós-Exposição
Sexo sem Proteção
description Fundação Faculdade de Medicina e Ministério da Saúde
publishDate 2019
dc.date.issued.fl_str_mv 2019
dc.date.accessioned.fl_str_mv 2020-09-18T16:08:12Z
dc.date.available.fl_str_mv 2020-09-18T16:08:12Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv GRANGEIRO, Alexandre et al. Nonoccupational post-exposure prophylaxis for HIV after sexual intercourse among women in Brazil: risk profiles and predictors of loss to follow-up. Medicine, [Baltimore], v. 98, n. 39, p.1-9, 2019.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/43451
dc.identifier.issn.pt_BR.fl_str_mv 0025-7974
dc.identifier.doi.none.fl_str_mv 10.1097/MD.0000000000017071
identifier_str_mv GRANGEIRO, Alexandre et al. Nonoccupational post-exposure prophylaxis for HIV after sexual intercourse among women in Brazil: risk profiles and predictors of loss to follow-up. Medicine, [Baltimore], v. 98, n. 39, p.1-9, 2019.
0025-7974
10.1097/MD.0000000000017071
url https://www.arca.fiocruz.br/handle/icict/43451
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dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Willams & Wilkins
publisher.none.fl_str_mv Willams & Wilkins
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
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