What are the public health policy issues related to PEP?
Katz and Gerberding think that public health messages regarding PEP therapy should ideally be part of an overall program of health promotion and HIV prevention. They feel that because the effectiveness of PEP will be maximal if administered as soon as possible after exposure, public health campaigns are needed that will inform people to seek medical attention within hours of HIV exposure. This must be accomplished without encouraging risky sexual or needle use behaviors. Katz and Gerberding’s report is likely to generate some controversy. It is not surprising that it was published in the “Sounding Board” section of The New England Journal of Medicine. An abundance of letters to the editor will probably follow. It will take some time to measure whether the benefits of PEP after sexual or needle use exposure reach statistical significance. Nonetheless, overwhelming evidence indicates that currently it is appropriate to have PEP therapy available. In San Francisco, a PEP program is schedu
