Limited awareness of the effective timing of HIV post-exposure prophylaxis among people with high-risk exposure to HIV

  • Daniel LeshinEmail author
  • Karen Olshtain-Pops
  • Allon Moses
  • Hila Elinav
Original Article


The effectiveness of post-exposure prophylaxis (PEP), a major strategy in the battle against HIV, depends on awareness of this modality and its proper timing among high-risk groups. While general awareness of PEP is improving, recently estimated to be 36–47% among men who have sex with men (MSM), PEP implementation remains disappointingly low and may be driven by limited awareness of effective PEP timing window. The level of detailed understanding of PEP timing and effectiveness among populations at risk has not been prospectively assessed to date. We prospectively evaluated, for the first time, actionable awareness regarding effective timing of PEP among a large cohort of individuals tested for HIV following unprotected sexual intercourse. Four hundred participants were assessed between December 2014 and February 2016. Overall awareness of the option of PEP was 60% and was significantly higher among male members of the LGBTQ community (75·5% as compared to 52·6% among heterosexual males) and those undergoing past HIV testing (67·1%). However, only 24% of individuals at risk were aware as to the proper timing of effective PEP treatment, thereby leading, in the majority of cases, to missing the window of opportunity for PEP treatment. This study highlights the lack of knowledge as to the specific requirements needed for effective PEP timing. Expanded advertising, better targeting of the heterosexual population, training of family physicians in the field of gender, sexuality, and LGBTQ medicine, may improve effective PEP availability, thereby reducing HIV transmission.


HIV Post-exposure prophylaxis Awareness 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the IRB committee of Hadassah-Hebrew University Medical Center.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

10096_2019_3476_MOESM1_ESM.docx (15 kb)
ESM 1 (DOCX 14 kb)


  1. 1.
    Smith DK, Grohskopf LA, Black RJ, Auerbach JD, Veronese F, Struble KA et al (2005) Antiretroviral postexposure prophylaxis after sexual, injection-drug use, or other nonoccupational exposure to HIV in the United States: recommendations from the U.S. Department of Health and Human Services. MMWR Recomm Rep 54:1–20Google Scholar
  2. 2.
    Rodriguez AE, Castel AD, Parish CL, Willis S, Feaster DJ, Kharfen M et al (2013) HIV medical providers’ perceptions of the use of antiretroviral therapy as nonoccupational postexposure prophylaxis in 2 major metropolitan areas. J Acquir Immune Defic Syndr 64(Suppl 1):S68–S79CrossRefGoogle Scholar
  3. 3.
    Mehta SA, Silvera R, Bernstein K, Holzman RS, Aberg JA, Daskalakis DC (2011) Awareness of post-exposure HIV prophylaxis in high-risk men who have sex with men in New York City. Sex Transm Infect 87:344–348CrossRefGoogle Scholar
  4. 4.
    Liu AY, Kittredge PV, Vittinghoff E, Raymond HF, Ahrens K, Matheson T et al (2008) Limited knowledge and use of HIV post- and pre-exposure prophylaxis among gay and bisexual men. J Acquir Immune Defic Syndr 47:241–247Google Scholar
  5. 5.
    Walters SM, Rivera AV, Starbuck L, Reilly KH, Boldon N, Anderson BJ et al (2017) Differences in awareness of pre-exposure prophylaxis and post-exposure prophylaxis among groups at-risk for HIV in New York State: New York City and Long Island, NY, 2011–2013. J Acquir Immune Defic Syndr 75(Suppl 3):S383–S391CrossRefGoogle Scholar
  6. 6.
    Dolezal C, Frasca T, Giguere R, Ibitoye M, Cranston RD, Febo I, et al. Awareness of post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP) is low but interest is high among men engaging in condomless anal sex with men in Boston, Pittsburgh, and San Juan. AIDSGoogle Scholar
  7. 7.
    HIV/AIDS in Israel: Periodic Epidemiological Report 1981–2016. In; 2017. Accessed 01 June 2018

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Internal Medicine AAssuta Ashdod HospitalAshdodIsrael
  2. 2.Hadassah AIDS Center, Clinical Microbiology and Infectious Diseases DepartmentHadassah-Hebrew University Medical CenterJerusalemIsrael

Personalised recommendations