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Sex Transm Infect 85:206-211 doi:10.1136/sti.2008.033662
  • Behaviour

Will I? Won’t I? Why do men who have sex with men present for post-exposure prophylaxis for sexual exposures?

  1. C Sayer1,
  2. M Fisher2,
  3. E Nixon2,
  4. K Nambiar2,
  5. D Richardson2,
  6. N Perry2,
  7. C Llewellyn1
  1. 1
    Brighton and Sussex Medical School, The Royal Sussex County Hospital, Brighton, UK
  2. 2
    Department of HIV/GUM Research Department, Brighton and Sussex University Hospitals, Elton John Centre, Brighton, UK
  1. Charlie Sayer, Brighton and Sussex Medical School, The Audrey Emerton Building, The Royal Sussex County Hospital, Eastern Road, Brighton, BN2 5BE, UK; charliesayer{at}doctors.org.uk
  • Accepted 18 November 2008
  • Published Online First 15 December 2008

Abstract

Background: Failures of post-exposure prophylaxis following sexual exposure (PEPSE) to prevent seroconversion have been reported and are often associated with ongoing risk exposure. Understanding why men who have sex with men (MSM) access PEPSE on some occasions and not others may lead to more effective health promotion and disease prevention strategies

Methods: A qualitative study design using semi-structured interviews of 15 MSM within 6 months of them initiating PEPSE treatment at an HIV outpatient service in Brighton, UK.

Results: PEPSE seeking was motivated by a number of factors: an episode that related to a particular sexual partner and their behaviour; the characteristics of the venue where the risk occurred; the respondent’s state of mind and influences of alcohol and recreational drug use; and their perceived beliefs on the effectiveness of PEPSE. Help was sought in the light of a “one-off” or “unusual” event. Many respondents felt they were less likely to behave in a risky manner following PEPSE.

Conclusion: If PEPSE is to be effective as a public health measure, at risk individuals need to be empowered to make improved risk calculations from an increased perception that they could be exposed to HIV if they continue their current behaviour patterns. The concern is that PEPSE was sought by a low number of MSM implying that a greater number are not using the service based on failure to make accurate risk calculations or recognise high-risk scenarios.

Footnotes

  • Funding: The study was funded exclusively by Brighton and Sussex University Hospitals NHS Trust.

  • Competing interests: None.

  • Contributors: CS was principal investigator responsible for study and interview design, data collection, primary analysis and presentation of results. MF was principal supervisor responsible for study conception and contributed to study and interview design and secondary data analysis. EN was clinical nurse consultant involved in recruitment and consent. KN was assistant supervisor and contributed to study and interview design. DR was assistant supervisor responsible for proof reading and amendments. NP was research manager responsible for the logistics of interviewing, transcription and funding. CL was supervisor of ethics, study design and secondary data analysis.