Important note: Information in this article was accurate in 1997. The state of the art may have changed since the publication date.
San Francisco Chronicle - The Voice of the West, 901 Mission Street, San Francisco, CA 94119 - Tuesday, October 14, 1997 - Page A2
David Perlman, Chronicle Science Editor
The first phase of the long- planned project involves treatment with the most powerful AIDS drugs available, in an attempt to prevent the virus from leading to outright disease.
Subjects will also receive intensive individual counseling on avoiding behavior that can cause repeated exposure to the virus -- such as risky sex or injection drug use.
The effort is known as "Post- Exposure Prevention," or PEP, and when the formal three-year research study begins January 1, it will enroll a total of 500 people. Treatment and counseling during a pilot phase of the project is now under way.
72-HOUR WINDOW
Individuals who fear they have been exposed to the AIDS virus in the previous 72 hours can obtain treatment and counseling at San Francisco General Hospital's Ward 4C and at the San Francisco City Clinic at 356 Seventh Street. Once the formal research project begins, detailed data on patients and the results of treatment and counseling will be carefully recorded. AIDS researchers will try to learn whether the program actually reduces dangerous sexual behavior among people most at risk for HIV infection, and whether an early attack with the best drugs available can forestall full- scale infection by HIV, which causes the deadly constellation of AIDS diseases.
Already, it is standard practice at most medical centers to offer anti-viral drugs promptly when AIDS workers are stuck with needles or come into contact with body fluids from infected patients.
The value and possible hazards of early intervention after risky sexual behavior have been debated among AIDS specialists for several years. At a meeting of the Centers for Disease Control and Prevention in Atlanta last July, officials voiced concerns that making anti-viral treatment so easily available might actually encourage people to become careless about unsafe sex.
San Francisco's Post-Exposure Prevention project is an attempt to answer that major question.
ASSESSING THE EFFECT
Starting in January, specialists at the University of California at San Francisco and the San Francisco Health Department will study whether the post-exposure prevention effort is safe for individuals and reduces AIDS transmission risks; whether individuals will comply with the rigorous treatment schedule; whether the anti- viral drugs can cause significant side effects; and whether individuals can be successfully counseled to change their risk behavior.
"If we find an increase in risky sexual behavior as a result of this effort, then it will be a failure," said Dr. Thomas Coates, director of the AIDS Research Institute at UCSF. "But the essential part of the effort is its client-centered, highly individualized and culturally oriented counseling program, and we hope to show that it is indeed effective," he said.
Although federal grants for the project are pending, the post-exposure prevention services will be available to all who seek them through private funding, and no one will be denied treatment, according to Coates and Dr. Mitch Katz, acting director of the city's Health Department. Dr. James Kahn of UCSF is clinical director of the Post-Exposure Prevention study.
Starting today, people who believe they have been exposed to HIV within the previous 72 hours can call the study at (415) 502-5737 (415-502-5-PEP), 24 hours a day.
More detailed information on the research project is available by calling (800) 367-2437 (800-FOR-
AIDS).
Information is also available on the Internet at hivinsite.ucsf.edu by clicking on "Key Topics."
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