Choosing event‐driven and daily HIV pre‐exposure prophylaxis – data from two European PrEP demonstration projects among men who have sex with men
| Autor: | Udi Davidovich, Hanne M L Zimmermann, Mark A M van den Elshout, Bea Vuylsteke, Vita W Jongen, Elske Hoornenborg, Henry J. C. de Vries, Liza Coyer, Maarten F. Schim van der Loeff, Tom Smekens, Kristien Wouters, Maria Prins, Thijs Reyniers, Marie Laga, Zorah M. H. Ypma |
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| Přispěvatelé: | APH - Methodology, APH - Global Health, Graduate School, AII - Infectious diseases, Dermatology, Infectious diseases, Medical Microbiology and Infection Prevention, Sociale Psychologie (Psychologie, FMG), Psychology Other Research (FMG) |
| Rok vydání: | 2021 |
| Předmět: |
Male
Sexual Behavior Short Report syphilis men who have sex with men HIV Infections Rate ratio Men who have sex with men Sexual and Gender Minorities Pre-exposure prophylaxis Humans Medicine Prospective Studies Homosexuality Male pre-exposure prophylaxis sexually transmitted infections pre‐exposure prophylaxis Chlamydia business.industry Incidence (epidemiology) event‐driven PrEP Public Health Environmental and Occupational Health Odds ratio medicine.disease event-driven PrEP Regimen Infectious Diseases Syphilis HIV prevention & control business Demography |
| Zdroj: | Journal of the International AIDS Society Journal of the International AIDS Society, 24(8):e25768. International AIDS Society |
| ISSN: | 1758-2652 |
| DOI: | 10.1002/jia2.25768 |
| Popis: | IntroductionDaily and event-driven PrEP are both efficacious in reducing the risk for HIV infection. However, the practice of event-driven PrEP (edPrEP) is less well studied, in particular when provided as an alternative to daily PrEP. We studied regimen preferences and switches, and sexually transmitted infection (STI) incidence.MethodsWe analysed pooled data from two prospective cohort studies among MSM: Be-PrEP-ared, Belgium and AMPrEP, the Netherlands. In both projects, participants could choose between daily and edPrEP at three-monthly study visits, when they were also screened for sexually transmitted infections including hepatitis C (HCV). We assessed the proportion choosing each regimen, and the determinants of choosing edPrEP at baseline. Additionally, we compared the incidence rates (IRs) of HCV, syphilis and chlamydia or gonorrhoea between regimens using Poisson regression. The study period was from 3 August 2015 until 24 September 2018.Results and discussionWe included 571 MSM, of whom 148 (25.9%) chose edPrEP at baseline. 31.7% of participants switched regimen at least once. After 28 months, 23.5% used edPrEP. Older participants (adjusted odds ratio (aOR) = 1.38 per 10 years, 95% confidence interval (CI) = 1.15 to 1.64) and those unemployed (aOR = 1.68, 95% CI = 1.03 to 1.75) were more likely to initially choose edPrEP. IR of HCV and syphilis did not differ between regimens, but the IR of chlamydia/gonorrhoea was higher among daily users (adjusted incidence rate ratio = 1.61, 95% CI = 1.35 to 1.94).ConclusionsA quarter of participants chose edPrEP at baseline and at 28 months this proportion was similar. Although the IR of HCV and syphilis were similar in the two regimens, the lower incidence of chlamydia and gonorrhoea among edPrEP users may suggest that less frequent STI testing of this group could be considered. |
| Databáze: | OpenAIRE |
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