LAUSR

Background/objectives Due to perceived increased tolerability and compliance, and decreased cost, recent trends in practice are moving towards using fewer drugs for HIV post‐exposure prophylaxis. However, there is limited literature to assess this is in the North American sexual assault victim population. Methods This retrospective before‐and‐after cohort study compared patients seen at a sexual assault care facility before and after the introduction of two and three‐drug post‐exposure prophylaxis regimens. Our primary outcome was completion of the 28‐day regimen. Secondary objectives included HIV seroconversion rates and patient reported side effects. Results Six‐hundred‐thirty charts from a 2‐year period were reviewed, and 429 met inclusion criteria. There was no difference in completion rates of post‐exposure prophylaxis between the two cohorts (50.5% vs. 51.6%). However, there were fewer reported side effects (72.2% vs. 17.6%) in the later cohort. We subsequently compared all patients in either cohort who received four‐drug therapy (N = 128) versus those who received two or three‐drug regimens (N = 47). The two or three‐drug regimen group had a higher completion rate (66.0% vs. 42.2%; p = 0.03), and a lower rate of reported side effects (19.1% vs. 53.9%), specifically for nausea (12.8% vs. 36.7%), constipation (0% vs. 7.9%), diarrhea (2.1% vs. 21.1%), mood changes (0% vs. 10.9%), headache (2.1% vs. 16.4%), and fatigue (6.4% vs. 26.6%). There were no HIV seroconversions in either group. Conclusion Two and three‐drug HIV post‐exposure prophylaxis regimens are better tolerated by patients and associated with greater compliance than four‐drug therapy, and could be considered in the sexual assault victim population.