news release
ANDREW J. SPANO, Westchester County Executive JOSHUA LIPSMAN, M.D., M.P.H., Commissioner of Health SUSAN TOLCHIN, Director of Communications

FOR IMMEDIATE RELEASE February 22, 2004

QUICK RESPONSE MAY HELP REDUCE TRANSMISSION OF HIV

No substitute for avoidance of risky behaviors

In the wake of recent media attention on the frightening possibility of a new, virulent strain of HIV, Joshua Lipsman, M.D., M.P.H., Commissioner of Health for Westchester County, points out that a bit of positive news concerning a treatment option that may prevent the transmission of HIV has been overlooked.  The Centers for Disease Control and Prevention is now recommending the use of antiretroviral medications to reduce the likelihood of transmission of HIV to a person who has had sexual or injection-drug use exposure with a known HIV-positive individual, within 72 hours of exposure.

These medications, available by prescription only, should be started as soon as possible after exposure – preferably within two hours, but no later than 72 hours. An individual who believes he or she has been exposed and would like to inquire about receiving this treatment should contact a primary care provider or go to a local hospital emergency department. The treatment must be taken under medical supervision, and follow-up care is essential. HIV testing, which may include some specialized tests, should be done as soon as possible after the exposure. HIV testing should be repeated again at six weeks, 12 weeks and 24 weeks after beginning treatment.

"While this treatment shows promise in helping to fight the spread of HIV, it should not give people a false sense of safety to engage in risky behaviors," said Dr. Lipsman. "To prevent HIV transmission, there is no substitute for abstaining from risky behaviors such as needle sharing or engaging in unprotected sex with someone whose HIV status you don’t know. This treatment method is certainly not an easy fix. The best way to prevent HIV infection is to avoid being exposed,” he noted.

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ANTIRETROVIRALS & HIV TRANSMISSION P.2

Reducing the likelihood of transmission of HIV through post-exposure medications is not 100% effective, but has been used by health care workers who have been accidentally exposed to HIV, usually from

an accidental needle stick with blood containing HIV. Although there have been no official recommendations, recent guidelines have permitted physicians to prescribe such treatment on a case by case basis for non-occupational exposures to HIV such as single occasions of unprotected sex, sharing needles or other drug-related materials, or for infants who have breast-fed on a single occasion from an HIV positive mother.

The treatment regimen is a 28-day course of antiretroviral drugs used to treat HIV infected individuals. These medications often cause immediate side effects that may be intolerable for some people. Many people who begin the treatment course don’t complete the entire course of treatment because of side effects. Adherence to treatment is also an important factor. The antiretrovirals must be taken as they are prescribed. If not, the treatment may not be successful or drug resistance may develop, limiting future treatment options. People who seek this treatment due to a sexual exposure will be counseled about how to prevent sexually transmitted diseases and to understand that the treatment cannot be relied on as a “morning-after pill” to prevent HIV infection.

For more information, please call the Westchester County Health Department at (914) 813-5000 or visit our website at www.wetschestergov.com/health.

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