P1-S6.52 Is PEP a misused therapy? Cross sectional PEP study in sex worker outreach program clinic
Bibliographic record
Abstract
Background Post-exposure prophylaxis (PEP) is a short-term anti-retroviral (ARV) treatment that reduces the likelihood of HIV infection after exposure to HIV-infected blood or sexual contact with an HIV-positive person. We are able to offer PEP mediations in our SWOP clinics to clients reporting high risk exposure. Normally ARVs for PEP are given within 72 h of exposure for a period of 4 weeks. Our objective was to assess whether the clients had already established STIs prior administration of PEP. The clients were aged between 19 and 49 years with each having an average of 9 men clients per day. Methods A cross sectional study was conducted on 91 female sex workers who came to the clinic for PEP in the period September 2009 to July 2010. The female sex workers were first given counselling, completed a standard questionnaire before having PEP administered. The samples taken included blood for HIV Elisa, high vaginal swab for Gonorrhoea Culture on Thayer martin media and Gram stain smear for Bacteria vaginosis, presence of spermatozoa and white blood cells. Results The clients were all HIV seronegative. 76% of the women had come for PEP for the first time, 21% for the second time and 3% for the third time. 80% of the patients reported condom burst, 8.6% were as a result of rape or coerced sex, while 3.2% reported client refused condom use. However 73% smears of the women did not have spermatozoa. Overall 9% of the patients were GC positive but 3.2% had GC and spermatozoa while 6.6% had GC without spermatozoa. Trichomonas prevalence was 4.3% but all these patients did not have spermatozoa. 38% had a WBC count of over 6–30 field on gram stain Conclusion: The presence of high white cell count at the time of seeking PEP may indicate a pre-existing infection, hence presence of underlying high risk behaviour. Moreover presence of GC and TV without spermatozoa may also indicate exposure longer reported. There is need to educate sex workers on proper use of PEP and to maintain low risk behaviour. We also need to understand the decision making process of sex workers in choosing post-exposure prophylaxis and any barriers that may contribute to delays in seeking PEP.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".