Prophylaxis after Sexual Exposure to HIV
Authors: Mitchell H. Katz
Journal: Annals of Internal Medicine (1998)

Letters15 October 1998Prophylaxis after Sexual Exposure to HIVMitchell H. Katz, MD and Julie Louise Gerberding, MD, MPHMitchell H. Katz, MDSan Francisco Department of Public Health; San Francisco, CA 94102University of California, San Francisco; San Francisco, CA 94143Search for more papers by this author and Julie Louise Gerberding, MD, MPHSan Francisco Department of Public Health; San Francisco, CA 94102University of California, San Francisco; San Francisco, CA 94143Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-129-8-199810150-00030 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We agree with Drs. Pinkerton and Holtgrave that using conventional-criteria postexposure prophylaxis is cost-effective only for sexual exposures that put persons at highest risk for seroconversion. We also agree that other forms of prevention are likely to be more cost-effective than postexposure prophylaxis. However, clinicians must always treat the patients in front of them. A patient with a recent sexual exposure to HIV has failed primary prevention. Our hope is that the intensive counseling that should accompany postexposure treatment will prevent future exposures. From this perspective, postexposure prophylaxis may be viewed as a method of motivating persons at ...References1. Tokars JI, Marcus R, Culver DH, Schable CA, McKibben PS, Bandea CI, et al. Surveillance of HIV infection and zidovudine use among health care workers after occupational exposure to HIV-infected blood. The CDC Cooperative Needlestick Surveillance Group. Ann Intern Med. 1993; 118:913-9. Google Scholar2. Flexner C. HIV-protease inhibitors. N Engl J Med. 1998; 338:1281-92. Google Scholar3. Cardo DM, Culver DH, Ciesielski CA, Srivastava PU, Marcus R, Abiteboul D, et al. A case–control study of HIV seroconversion in health care workers after percutaneous exposure. Centers for Disease Control and Prevention Needlestick Surveillance Group. N Engl J Med. 1997; 337:1485-90. Google Scholar4. Update: provisional Public Health Service recommendations for chemoprophylaxis after occupational exposure to HIV. MMWR Morb Mortal Wkly Rep. 1996; 45:468-80. Google Scholar5. Guidelines for the management of health-care worker exposures to HIV and recommendations for postexposure prophylaxis. MMWR Morb Mortal Wkly Rep. 1998; 47(RR-7):1-33. Google Scholar Author, Article, and Disclosure InformationAuthors: Mitchell H. Katz, MD; Julie Louise Gerberding, MD, MPHAffiliations: San Francisco Department of Public Health; San Francisco, CA 94102University of California, San Francisco; San Francisco, CA 94143 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 October 1998Volume 129, Issue 8Page: 672KeywordsEmergency departmentHealth careHIVHIV preventionPatientsPostexposure prophylaxisPrevention, policy, and public healthProphylaxisProtease inhibitorsStomach ePublished: 15 August 2000 Issue Published: 15 October 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...