Prescription of Postexposure Prophylaxis for HIV-1 in the Emergency Room: Correct Transmission Risk Assessment Remains Challenging.

摘要: Background Limited data are available about the accuracy of postexposure prophylaxis (PEP) prescription in emergency rooms. Here, we evaluated PEP decision making with respect to risk sexual HIV transmission and exposed person's fear vis-a-vis HIV. Methods Using a assessment algorithm, retrospectively adequacy for all persons presenting at room University Hospital Zurich after consensual sex from 2007 2013. We used logistic regression identify factors that correlate risk-concordant risk-discordant decisions. Results documented 975 total 1051 visits PEP: 83% were men, 71% Swiss, 37% men who have men. In 74% visits, decisions concordant evaluation algorithm (22% discordant, 4% unknown). 61% (644/1051) was prescribed; however, 12% (76/644) prescriptions without indication attributed request. Importantly, 10% (101/1051) there potential risks but not prescribed, either because physician's or refusal. The presence source partner strongly correlated appropriately withholding (adjusted odds ratio giving 0.05; 95% confidence interval: 0.03 0.08). Conclusions found 22% discordant request, incorrect estimation by physician, refusal accept PEP. Emergency physicians may benefit specialized training patients education awareness.