HIV PEP (post-exposure prophylaxis) is a combination of anti-HIV medications given to prevent HIV infection after potential exposure to the virus. HIV PEP has been recommended to prevent transmission of HIV following non-occupational sexual exposure (Centers for Disease Control and Prevention, 2005), but at that time the available research and guidelines to practically implement this recommendation were limited and often inconsistent.

The HIV PEP Study was initiated by the Ontario Network of Sexual Assault/Domestic Violence Care and Treatment Centres (SATCs) and funded by the Ontario Women's Health Council (OWHC). The Ontario Network of SATCS turned to WCRI to help create a study testing an appropriate approach for implementing HIV PEP in Ontario sexual assault treatment centres. The study was led by Drs. Mona Loutfy and Anita Rachlis with co-investigators Sheila Macdonald, Terri Myhr and Janice Du Mont. Heather Husson served as the research coordinator for most of the life of the study.

The HIV PEP study offered HIV prophylaxis universally to all victims of sexual assault at risk. It collected data prospectively to identify factors crucial to enabling an effective and sustainable province-wide response. The universal HIV PEP program implemented as part of this study included the following characteristics:

• All clients to receive counselling about potential HIV risks;
• All clients whose assault poses any risk of HIV infection (known or unknown)to be offered prophylactic medication;
• Prophylaxis to be "strongly recommended" for clients assessed to be at high-risk of infection;
• Prophylaxis to begin within 72 hours of exposure;
• Prophylaxis to be prescribed for a period of 28-days;
• An intensive schedule of five follow-up visits to assist clients who choose the prophylactic drugs to cope with side effects and complete the medication course; and,
• Prophylaxis to be provided at no cost to clients.

During the HIV PEP Study, data was collected on 1,103 consecutive sexual assault victims/survivors presenting to 24 participating SATCs from September 2003 - January 2005. Findings from the HIV PEP Study indicated that a universal HIV PEP program:

• Was well-received and appreciated by sexual assault victims/survivors
• Enabled health care providers to effectively support all clients at risk of HIV acquisition in their HIV PEP decision-making
• Improved the quality of sexual assault care in Ontario

These findings as well as recommendations for an ongoing HIV PEP program were communicated to the Ontario Ministry of Health and Long-Term Care in the study's final report, submitted December 21, 2005. Based on the HIV PEP Study's final report and recommendations, the Ontario Ministry of Health and Long-Term Care is providing ongoing base funding to support the universal offering of HIV PEP medications at Ontario's 34 Sexual Assault/Domestic Violence Treatment Centres, effective September 2006.

Since the study was completed, WCRI has worked with the Ontario Network of Sexual Assault/Domestic Violence Care and Treatment Centres (SATCs) to help create evidence based training and resources to implement in every Ontario SATC and to disseminate these findings to other jurisdictions. The project has received a Phase 1 and Phase 2 Knowledge to Action grant from the Canadian Institutes of Health Research. Learn more about the Knowledge-to-Action project.