Naslov
Prevention of HIV infection in travelers

Autori
Lukas, Davorka ; Begovac, Josip

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
1st Croatian Congress on Travel, Tropical, Migration Medicine & HIV with International Participation - Book of Abstract / - , 2015

Skup
1st Croatian Congress on Travel, Tropical, Migration Medicine & HIV with International Participation

Mjesto i datum
Dubrovnik, Hrvatska, 01.10.2015. - 04.10.2015

Vrsta sudjelovanja
Predavanje

Vrsta recenzije
Nije recenziran

Ključne riječi
HIV; travelers; prevention

Sažetak
HIV can be transmitted from one person to another through: unprotected sexual contact (anal, oral, vaginal) ; shared needles or equipment for injection drug use ; unsterilized needles for tattooing, bodyGpiercing or acupuncture ; blood transfusions or organ transplantation ; artificial insemination ; from an HIVGinfected mother to her infant (during pregnancy, delivery and breast feeding) ; exposure to blood and other potentially infectious body fluids via percutaneous injury or splash exposures to mucous membranes or nonGintact skin. HIV infection occurs worldwide. Although the prevalence and incidence of HIV infection, differs between countries significantly, the risk for international travelers is generally determined less by geographic destination and more by behavior such as unprotected sex and drug use. Geographic destination plays an important role for those travelers who might undergo medical procedures, whether scheduled or in an emergency, in developing countries where the blood supply, organs and tissues used for transplantation might not be adequately screened whish increase the risk of HIV transmission. Since, there is no vaccine available to prevent HIV infection, all travelers should be informed about the risk and routes of transmission of HIV infection. As a part of preGtravel advice, health care provider should inform travelers how to reduce their risk of acquiring HIV infection and advice to: avoid unprotected sex (anal, oral or vaginal) and to use condoms consistently, to avoid heavy partying, drinking or taking illegal drugs, which can change sexual inhibitions or alter ability to make decisions, to avoid sharing needles, syringes, toothbrushes or shavers ; to avoid exposure to unsterilized needles for tattooing, bodyGpiercing or acupuncture, avoid injections, blood transfusions and organ transplantations unless it is an emergency. Regarding preGtravel advice, special attention should be given to HIV postexposure prophylaxis (HIV PEP) with antiretroviral drugs. Travelers who have been exposed to HIV in a nonoccupational setting (through sex or needle sharing) or occupational setting (those working in a medical setting), should seek immediate medical consultation to consider postexposure prophylaxis. HIV PEP consists of a combination of antiretroviral drugs that should be started as soon as possible after exposure (preferably within 4 hours) and up to 72 hours after exposure. HIV PEP is to be taken regularly, on a daily basis for 28 days. HIV preexposure prophylaxis (PrEP) is not in routine practice, but since 2014 is recommended in many guidelines (US CDC, IASGUSA, BHIVA, WHO) for sexually active MSM, heterosexually active men and women, injection drug users at substantial risk of HIV acquisition because of risky behavior. The Proud study (daily oral emtricitabine plus tenofovir (TDF/FTC) and Ipergay study (“on demand” oral PrEP with TDF/FTC) showed a reduction of HIV incidence of 86% (95% CI: 40G96) and 86% (95% CI 58G96) respectively. PrEP could be a future option for prevention of HIV infection in travelers who practice very risky behavior. Each traveler is to be advised to see a health care provider immediately after possible exposure to HIV infection in order to be tested, counselled and treated as appropriate.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA