Current research highlights that beneficial HIV prevention outcomes occur when HIV medications are administered within 72 hours of a possible HIV exposure. This strategy, which is known as HIV post-exposure prophylaxis (PEP), makes the period immediately following a potential sexual exposure to HIV an important window for HIV prevention. The pressing need for an evidence-informed implementation of HIV PEP is due to the fact that, in Canada, most HIV transmission occurs through sexual contact. Recent Public Health Agency of Canada HIV surveillance reports indicated that sexual contact accounted for 81.9% of HIV transmission among men.
Currently, however, HIV PEP is only available from emergency departments in Ontario, and this approach to providing PEP deters some persons from initiating these medications. Problematically, the extant literature indicates that long wait times and discomfort discussing sexual histories with emergency department staff deter some persons who need HIV PEP from accessing emergency departments to obtain these HIV prevention medications.
Accordingly, we have proposed a twelve-month trial of community-based PEP delivery for potential sexual exposures to HIV among gay, bisexual, and other men who have sex with men. The proposed project will expand the opportunities for timely PEP initiation among the just-noted persons by increasing the number of settings where PEP is available. The evaluation of this project will involve both a review of the clinical information from persons who initiated PEP as part of this project, and follow-up interviews. This will evaluate PEP administration in community-based sexual health clinics.
The Canadian Institutes of Health Research (CIHR) and Kelly and colleagues framework for effective knowledge translation in the field of HIV/AIDS guides the dissemination plan for the proposed pilot study. Consequently, the following will occur:
- A synopsis of the material that was discussed at the meeting will be complied into a readily accessible document. Printed and bound copies will be sent to each of the participants, as well as to the health departments, sexual health centres, HIV care clinics in Ottawa, Toronto, London, etc. Moreover, this document will be hosted for free download from the University of Ottawa library Web site; this will ensure that the Canadian public has full access to this document.
- Presentations will be given to community-based workers who provide front-line HIV/AIDS care in Ottawa. This will ensure individuals who could use this information in their daily work have access to it.
- The applicants will present the outcomes of this meeting to relevant governmental agencies (e.g., health units in Ottawa, Toronto, etc., and national level organizations in Ottawa, e.g., PHAC), and at the annual OHTN conference. In combination, these steps will ensure thorough dissemination of our work