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HIV seroconversions among male non-occupational post-exposure prophylaxis service users: a data linkage study

Anna B. Pierce A F , Keflemariam Yohannes B , Rebecca Guy C , Kerrie M. Watson A , Jude Armishaw A , Brian Price A , Jennifer F. Hoy A D , Edwina J. Wright A D E and Mark A. Stoové B
+ Author Affiliations
- Author Affiliations

A Victorian NPEP Service, Infectious Diseases Unit, The Alfred Hospital, Melbourne, Vic. 3004, Australia.

B Centre for Population Health, Burnet Institute, Melbourne, Vic. 3004, Australia.

C National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Sydney, NSW 2010, Australia.

D Department of Medicine, Monash University, Melbourne, Vic. 3004, Australia.

E Centre for Virology, Burnet Institute, Melbourne, Vic. 3004, Australia.

F Corresponding author. Email:

Sexual Health 8(2) 179-183
Submitted: 3 June 2010  Accepted: 31 August 2010   Published: 18 May 2011


Background: Despite widespread prescription of non-occupational post-exposure prophylaxis (NPEP) in Victoria, little is known about subsequent HIV acquisition among NPEP users. We linked the Victorian NPEP Service (VNPEPS) database and the Victorian HIV Surveillance Registry to determine the number, incidence rate and predictive factors of HIV seroconversions among users of the VNPEPS. Methods: Records from male patients that received NPEP in the VNPEPS database (n = 1420) between January 2001 and February 2008 were linked with all entries in the Victorian HIV Surveillance Registry up to May 2008. Results: Sixty-one men who presented to the VNPEPS were identified as HIV seropositive; 16 of these were diagnosed at initial presentation for NPEP. The incidence of HIV seroconversion in males who were HIV seronegative at first presentation for NPEP was 1.27 (95% confidence interval 0.95–1.70) per 100 person-years. There was no association between HIV seroconversion and number of NPEP presentations or age. The median age of seroconversion was 34.6 years. Conclusion: The incidence of HIV infection among men presenting to the VNPEPS is slightly lower than the HIV incidence in NPEP users in a recent Australian cohort study of men who have sex with men, but higher than HIV incidence in general gay male populations. Frequency of NPEP use was not associated with risk of HIV seroconversion. Examination of risk behaviour before and after NPEP use in this population is required to further assess the impact of NPEP availability and use on HIV incidence rates and risk behaviour in Australia.

Graphical Abstract Image

Additional keywords: AIDS, Australia, HIV incidence, HIV prevention.


The authors thank all doctors and clinics that are part of the Victorian NPEP Service. We would also like to thank Carol El-Hayek and Danielle Horyniak, who maintain the Victorian HIV Surveillance Registry, and Stacey Aitchison and Rincy Mathew for the VNPEPS data management. The Victorian NPEP Service is funded by the Victorian Department of Health.


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