IS IT SAFE TO PROVIDE 28 DAY POST-EXPOSURE PROPHYLAXIS (PEP) PACKS IN SEXUAL HEALTH SERVICES, EMERGENCY DEPARTMENTS AND SEXUAL ASSAULT REFERRAL CENTRES?

Introduction Since the beginning of COVID lockdown, we have provided 28 day PEP packs from sexual health clinics, emergency departments and sexual assault referral centres to minimise number of patient contacts. This study is to look at the provision of PEP since the new initiative. Methods Patients who attended our hospital emergency department, sexual assault referral centre, and sexual health clinics between March 2020 and October 2021 were randomly selected. Retrospective patient records were reviewed and the BHIVA 2015 PEP standards were used. Results 434 patients and 468 PEP prescriptions were included. 384 (88%) were male, in whom 337 (87.8%) were MSM. 166 (38.2%) were from our emergency department. 401 (85.7%) were after sexual exposure, 56 (20.0%) were occupational exposure. 413 (88.2%) prescriptions met criteria for initiation, 43 (9.2%) did not and 3 (0.6%) had insufficient information. 448 (95.7%) had baseline blood tests. 28 (6%) did not attend sexual health clinic for follow up. 255 (54.5%) had repeat HIV test after 8-12 weeks of exposure. 213 (45.5%) did not have repeat test. STI screening was performed in 368 (78%) attendances and 106 infections were identified. Discussion The majority of PEP was prescribed appropriately and baseline testing was performed in most cases. Out study demonstrates the safety of 28-day PEP pack being issued in settings other than sexual health clinics. Post-PEP HIV testing remains poor, which is consistent with other national audits. This highlights the need for focussed work to improve followup attendance.

Clinical Qualification of DNA Repair Defects as Biomarkers in Metastatic Prostate Cancer Using Integrated Genomics and Tissue Based Functional Assays

We and others previously described an enrichment for somatic and germline alterations in DNA damage repair (DDR) genes among men with metastatic prostate cancer. Several recent clinical studies have indicated many of these patients could benefit from precision medicine strategies with PARP inhibitors and DNA damaging agents. In this project, our teams would investigate genomic, transcriptomic and protein related functional signatures for a more accurate sub-classification of prostate cancers associated to DDR defects, aiming for a more precise patient care. The project is divided in 3 main aims: 1) testing the prognostic value of somatic DDR defects in a retrospective cohort of tumor biopsies, 2) developing multi-omics signatures based on prospective analyses of metastatic biopsies and 3) clinical validation of these biomarkers in a clinical trial using carboplatin as DNA damaging chemotherapy.