Adherence to PrEP Among Young Men Who Have Sex With Men Participating in a Sexual Health Services Demonstration Project in Alameda County, California
| Autor: | Remi Frazier, Kimberly A. Koester, Rebecca Packard, Robert M. Grant, Xavier A Erguera, Kristin Kennedy, Ifeoma Udoh, Janet J. Myers, Jessica Horowitz, Jeffrey H. Burack, Mi-Suk Kang Dufour |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Adolescent media_common.quotation_subject Sexual Behavior Psychological intervention HIV Infections Emtricitabine California Men who have sex with men Medication Adherence Young Adult medicine Humans Pharmacology (medical) Homosexuality Young adult Homosexuality Male Reproductive health media_common business.industry Adenine Odds ratio Organophosphates Black or African American Infectious Diseases Pre-Exposure Prophylaxis Sexual Health business Psychosocial Demography medicine.drug |
| Zdroj: | Journal of acquired immune deficiency syndromes (1999). 81(4) |
| ISSN: | 1944-7884 |
| Popis: | Author(s): Myers, Janet J; Kang Dufour, Mi-Suk; Koester, Kimberly A; Udoh, Ifeoma; Frazier, Remi; Packard, Rebecca; Kennedy, Kristin; Erguera, Xavier; Horowitz, Jessica; Grant, Robert; Burack, Jeffrey H | Abstract: BackgroundYoung men of color who have sex with men face a continual increase in rates of HIV infection. Pre-exposure prophylaxis (PrEP) is an important prevention method for these young men.SettingThe Connecting Resources for Urban Sexual Health (CRUSH) demonstration project provided sexual health services, including PrEP, to young men who have sex with men aged 18-29 years. We report on adherence and factors influencing it.MethodsParticipants were offered HIV and sexually transmitted infection testing, prevention counseling, PrEP, and when appropriate, sexually transmitted infection treatment and postexposure prophylaxis. Participants taking PrEP had erythrocyte tenofovir diphosphate and emtricitabine levels measured through dried blood spot testing at 4, 12, and 24 weeks to estimate medication adherence. Participants also completed surveys to assess demographic and psychosocial measures.ResultsFrom February 2014 to November 2015, CRUSH enrolled 257 participants. Ninety-three percent started PrEP, 81% of whom initiated it at their first visit. Twelve percent required postexposure prophylaxis before starting PrEP. Adherence at protective levels was initially high with 87% demonstrating levels consistent with at least 4 doses per week at week 4, compared with 77% at the 48-week follow-up. African American race, exposure to violence, and having survival needs were associated with significantly lower levels of adherence [odds ratio (OR): 0.33; confidence interval (CI): 0.11 to 0.97, P l 0.04; OR: 0.79; CI: 0.59 to 1.04, P l 0.10; OR: 0.51; CI: 0.24 to 1.05, P l 0.07].ConclusionsMost young men who initiate PrEP adhere at levels that confer protection against HIV infection. Interventions should account for differences in life experiences, particularly addressing the structural challenges facing young African American men. |
| Databáze: | OpenAIRE |
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