Factors contributing to repeat pepse in msm

Background/introduction PEPSE is a significant tool for preventing HIV transmission among MSM. Further understanding is required on the extent and risk factors for repeat PEPSE (rPEPSE) presentations. Aims/objectives This study aimed to determine the rate of repeat PEPSE and identify factors involved in rPEPSE presentations. Methods MSM attending for PEPSE in Brighton, May 2009–May 2014 were included. Information was collected retrospectively on demographics, number of rPEPSE prescriptions, recreational drug and alcohol use, type of sexual exposure, condom use, mental health (MH), continued risk taking while on PEPSE, partner factors, PEPSE regime and risk reduction interventions. Data were analysed using Excel functions (Spearmann’s rank correlation coefficient). Results 929 MSM accessed PEPSE – 110 (11.5%) had repeat PEPSE prescriptions (48.2% twice, 25.5% 3×, 9.1% 4×, 7.3% 5×, 6.4% 6×, 1.8% 7×, 1.8% 8× and 0.9% 9×). rPEPSE prescriptions were associated with low condom use (25.2% used condoms), MH problems (43.9% had at least one recorded) and alcohol/recreational drug use (49.1% patients had used alcohol prior to their attendance for rPEPSE, 40% had used drugs). Those with > 4 episodes rPEPSE reported more recreational drug use (significant association: (p = 0.04). Lower numbers of rPEPSE prescriptions (2/3) were associated with alcohol use (p = 0.07). 6.4% of those accessing rPEPSE became HIV positive. Discussion/conclusion This study identified an 11.5% rate of rPEPSE among MSM in this area and highlights contributory factors to rPEPSE and could help inform behavioural and risk reduction interventions at a local level.