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April 14, 1999

Postexposure Prophylaxis Following HIV Exposure—Reply

Author Affiliations

Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor

JAMA. 1999;281(14):1269. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-14-jac90002

In Reply: Dr Barry accurately points out some of the limitations of local HIV serosurveillance or research data. Although we certainly agree with these points, it remains true that many source patients will be inaccessible or may not provide accurate information when interviewed, given the stigmatized nature of male-male intercourse and injection drug use. The existing data may not be perfect but, together with interviewing and voluntary HIV testing of source patients, we believe the clinician can make a more informed decision if these data are available. Even imperfect data usually can distinguish between seroprevalence rates of less than 1%, which exist in many populations, and the very high seroprevalence rates (30%-50%) in certain populations in large cities. This information may be the difference between prescribing PEP and not prescribing it.

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