Post Exposure Prophylaxis
Following an expert think tank seminar on PEP at the end of 2003 (and a briefing for the HIV sector that followed early 2004) CHAPS ran a PEP pilot campaign in July 2004 in the two UK cities with the highest HIV prevalence among gay men, London and Brighton.
These cities were chosen as a number of sexual health clinics there agreed to be listed as places men could access PEP. After the successful pilot campaign, and with more clinics supporting the availability of PEP for sexual exposure, the campaign was expanded across England and Wales in June 2005.
Prior to the launch of the campaign sexual health clinics in England and Wales were contacted by letter to advise them of the campaign. Early 2006 the Chief Medical Officer wrote to key sexual health stakeholders recommending the use of PEP following sexual exposure. Subsequently the PEP campaign was rerun late 2006/early 2007 with added emphasis on accessing PEP as soon as possible. It ran again in late 2007.
Before any CHAPS PEP work took place the Gay Men’s Sex Survey of 2003 showed around only 1 in 5 men (22%) had heard of PEP. In the sex survey of 2005 awareness of PEP had risen to 38.5% and by 2007 had reached 56%, a doubling within four years.
The aim of the campaign
- To make men aware of the existence of PEP
This reflects aim 4 of the CHAPS strategy Making It Count concerned with increasing the numbers of men taking PEP following sexual exposure to HIV.
Subaims involve increasing the number of men who know:
- PEP must start within 72 hours of exposure to HIV
- Treatment is not 100% certain to work
- It involves taking HIV drugs for one month
- Locations where men can access PEP
- Circumstances in which PEP is given
Given concern that promoting PEP might undermine condom use, the campaign stressed that PEP was no substitute for condoms, was an emergency ‘last resort’ option and could cause side effects such as nausea, diarrhoea and headaches.
Referral information signposted men to THT Direct, to a leaflet available in gay venues and an online self assessment tool which would give clinic details to men meeting PEP prescription criteria (while dissuading men who did not from trying to access the treatment).
Campaign message
The PEP campaign had one message in its mass media components:
PEP is a one month course of HIV drugs that if taken within 72 hours of sexual exposure to HIV may prevent infection.
Target audience
The 2004 pilot campaign was aimed at gay men (regardless of HIV status) in Brighton and London. With the national roll out in 2005 all gay men in cities with significant HIV prevalence in England and Wales became the target. The campaign aimed to be disproportionately seen by men aged 20-35, those on the gay scene and those with higher numbers of sexual partners.
Materials supporting the campaign
For the 2004 and 2005 PEP activity the following were produced:
- Press ads
- A4 poster (English and Welsh)
- A0 poster
- A6 sized leaflet (inserted in the gay press in 2006)
- Credit card wallet card
- Concertina wallet-size leaflet
- Website with self assessment tool, experiences of users of PEP and information for professionals
- Internet banner ads
Outreach support materials were:
- Confectionery
- Fridge magnets
- T-shirts
- PEP quiz card
- Stickers
Campaign briefing
PEP training seminar for outreach workers, volunteers and helpline workers
An ‘implementation pack’ was produced covering frequently asked questions about promoting PEP access (eg, cost effectiveness and impact on risk taking), lobbying for its availability, supporting the campaign locally, summary of UK PEP prescription guidelines.
The briefing report for the HIV sector about PEP that was available to support the campaign was updated in 2006 and 2010.
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