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4CPS-220 Evaluation of the implementation of a pre-exposure prophylaxis programme: 2 years experience in our region
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  1. J Garcia-Calvo Navarro1,
  2. M López López-Cepero1,
  3. T García Ruiz1,
  4. H Padilla Castaño1,
  5. J Serra Esteban2,
  6. M Riera Jaume3,
  7. O Delgado Sánchez1
  1. 1Hospital Universitari Son Espases, Hospital Pharmacy, Palma De Mallorca, Spain
  2. 2Hospital Comarcal D’inca, Internal Medicine, Palma De Mallorca, Spain
  3. 3Hospital Universitari Son Espases, Internal Medicine, Palma De Mallorca, Spain

Abstract

Background and Importance HIV remains a significant social and economic problem. Recently, continuous use of antiretrovirals (mtricitabina/tenofovir) have been used as pre-exposure prophylaxis (PrEP) with positive clinical and economic outcomes. However, the use of drugs in individuals without pathology can be controverted due to the potential exposure to toxic effects.

Aim and Objectives To study the sociodemographic characteristics, effectiveness, and safety of PrEP in the users of our region.

Retrospective study Period August 2021 to September 2023. Variables: gender, age, risk behaviours, sexually transmitted infections (STI), chemsex, adherence, serology, side effects, discontinuation.

Results 303 users enrolled from August 2021 to September 2023. There are 297 males, four transgender women, one female, and one non-binary. Users’ age distribution was: <25 (2%), 25–34 (28%), 35–44 (43%), 45–54 (20%), 55–64 (5%), and >65 (1%).

58% were engaged in three or more risk behaviours. >10 sexual partners during last year (93%), no condom (85%) and a sexually transmitted infection (STI) in the last year (52%). Approximately 37% reported drug use, mostly poppers (80%), cocaine, marijuana, ecstasy and GHB (around 35% each), speed (24%), and ketamine (14%). 326 STIs were diagnosed: 51% gonorrhoea, 32% chlamydia, and 17% syphilis. Only 70% of users reported a perfect adherence. None became infected with HIV.

Regarding safety, 19% experienced adverse effects, almost all of which were mild and self-limiting. Gastrointestinal disorders (13%), nausea (6%), and headache (3%) were the most common adverse effects. 27 users discontinued the programme. 10 of them due to renal impairment, four from adverse effects, and 13 for personal reasons. Average serum creatinine deviation from baseline at 1, 3, 6, 12, 18 and 24 months was 0,02 ± 0,2 mg/dL for every period.

Conclusion and Relevance PrEP is an effective and safe strategy for preventing HIV infection in individuals practising risky behaviors, the majority being young adults with higher education or further and employed. Follow-up programmes allow for the detection and treatment of multiple STIs to reduce their spread, requiring a specialised team to provide the necessary treatment and education. Interestingly, renal function was not affected at least in short term use within two years and despite low adherence, no user was infected by HIV.

Conflict of Interest No conflict of interest.

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