Do we promote pre-exposition prophylaxis in the emergency service?

Dear Editor,

In the original article, “Experiencia de un programa de profilaxis preexposición en una unidad de virus de la inmunodeficiencia humana hospitalaria. Descripción del perfil basal del usuario e identificación de oportunidades de mejora” [Experience of a pre-exposure prophylaxis programme in a human immunodeficiency virus hospital unit. Description of the user’s baseline profile and identification of opportunities for improvement],¹ the authors explain that there were five possible origins for referral to a pre-exposure prophylaxis (PrEP) consultation: from a hospital consultation, on the person’s own initiative or suggestion by friends, from his or her primary care physician, from non-governmental organisations (NGOs) or from a community centre (Table 1 of the article). We believe that it would be interesting to find out how many patients who accessed this consultation were referred from the accident and emergency department. As is well known, accident and emergency departments are places where “missed opportunities” often occur regarding early diagnosis and prevention of human immunodeficiency virus (HIV) infection and other sexually transmitted infections.² In the United Kingdom, the National Institute for Health and Care Excellence (NICE) has been recommending routine HIV testing in all accident and emergency departments in high-prevalence areas since 2016.³ Therefore, as the authors themselves recognise, there are further opportunities for improving the implementation of pre-exposure prophylaxis programmes.