scholarly journals COVID-19 Pandemic, Pre-exposure Prophylaxis (PrEP) Care, and HIV/STI Testing Among Patients Receiving Care in Three HIV Epidemic Priority States

2021 ◽  
Vol 25 (5) ◽  
pp. 1361-1365
Author(s):  
Brandon J. Hill ◽  
Brie Anderson ◽  
Li Lock
Keyword(s):  
Sti Testing ◽  
Hiv Epidemic ◽  
Exposure Prophylaxis

scholarly journals PrEP Continuation, HIV and STI Testing Rates, and Delivery of Preventive Care in a Clinic-Based Cohort

2018 ◽  
Vol 30 (5) ◽  
pp. 393-405 ◽  
Author(s):  
Matthew A. Hevey ◽  
Jennifer L. Walsh ◽  
Andrew E. Petroll
Keyword(s):  
Clinical Trials ◽  
Preventive Care ◽  
Retention In Care ◽  
Clinical Settings ◽  
Hiv Incidence ◽  
Sti Testing ◽  
Hiv And Sti Testing ◽  
Study Completion ◽  
Exposure Prophylaxis

HIV pre-exposure prophylaxis (PrEP) has been demonstrated to be a safe and effective method of reducing HIV incidence. Questions remain regarding PrEP's efficacy and outcomes in real-world clinical settings. We conducted a retrospective review to assess PrEP outcomes in an academic clinic setting and focused on retention in care, reasons for discontinuation, and receipt of appropriate preventive care (immunizations, HIV testing, and STI testing). One hundred thirty-four patients were seen between 2010 and 2016 over 309 visits. One hundred sixteen patients (87%) started daily PrEP and of those, 88 (76%) attended at least one 6-month follow-up visit. Over 60% of PrEP patients completed all recommended STI screening after starting PrEP. Only 40% of patients had all appropriate immunizations at baseline; 78% had all appropriate immunizations at study completion. This study demonstrated high rates of both retention and of attaining recommended preventive care in a clinical setting outside of the rigors of clinical trials.

scholarly journals The Potential Impact of Long-Acting Cabotegravir for HIV Prevention in South Africa: A Mathematical Modeling Study

2020 ◽  
Author(s):  
Jennifer A Smith ◽  
Geoffrey P Garnett ◽  
Timothy B Hallett
Keyword(s):  
South Africa ◽  
Hiv Risk ◽  
Adult Population ◽  
Phase Iii ◽  
Substantial Impact ◽  
Hiv Epidemic ◽  
Phase Iii Trials ◽  
Long Acting ◽  
Exposure Prophylaxis ◽  
The Impact

Abstract Background Although effective, some oral pre-exposure prophylaxis (PrEP) users face barriers to adherence using daily pills, which could be reduced by long-acting formulations. Long-acting cabotegravir (CAB LA) is a potential new injectable formulation for human immunodeficiency virus (HIV) PrEP being tested in phase III trials. Methods We use a mathematical model of the HIV epidemic in South Africa to simulate CAB LA uptake by population groups with different levels of HIV risk. We compare the trajectory of the HIV epidemic until 2050 with and without CAB LA to estimate the impact of the intervention. Results Delivering CAB LA to 10% of the adult population could avert more than 15% of new infections from 2023 to 2050. The impact would be lower but more efficient if delivered to populations at higher HIV risk: 127 person-years of CAB LA use would be required to avert one HIV infection within 5 years if used by all adults and 47 person-years if used only by the highest risk women. Conclusions If efficacious, a CAB LA intervention could have a substantial impact on the course of the HIV epidemic in South Africa. Uptake by those at the highest risk of infection, particularly young women, could improve the efficiency of any intervention.

scholarly journals Prevalence of HIV and sexually transmitted and blood-borne infections, and related preventive and risk behaviours, among gay, bisexual and other men who have sex with men in Montreal, Toronto and Vancouver: results from the Engage Study

2021 ◽  
Author(s):  
Trevor A. Hart ◽  
David M. Moore ◽  
Syed W. Noor ◽  
Nathan Lachowsky ◽  
Daniel Grace ◽  
...  
Keyword(s):  
Scale Up ◽  
Hiv Prevalence ◽  
Risk Behaviours ◽  
Syphilis Infection ◽  
Sexually Transmitted ◽  
The Past ◽  
Sti Testing ◽  
History Of ◽  
Sex With Men ◽  
Exposure Prophylaxis

Abstract Objectives The last Canadian biobehavioural surveillance study of HIV and other sexually transmitted and blood-borne infections (STBBI) among gay, bisexual and other men who have sex with men (GBM) was conducted in 2010. We designed a study to measure STBBI prevalence among GBM in metropolitan Montreal, Toronto and Vancouver and to document related preventive and risk behaviours. Methods The Engage Cohort Study used respondent-driven sampling (RDS) to recruit GBM who reported sex with another man in the past 6 months. At baseline, we examined recruitment characteristics of the samples, and the RDS-II-adjusted distributions of socio-demographics, laboratory-confirmed HIV and other STBBI prevalence, and related behaviours, with a focus on univariate differences among cities. Results A total of 2449 GBM were recruited from February 2017 to August 2019. HIV prevalence was lower in Montreal (14.2%) than in Toronto (22.2%) or Vancouver (20.4%). History of syphilis infection was similar across cities (14–16%). Vancouver had more HIV-negative/unknown participants who reported never being HIV tested (18.6%) than Toronto (12.9%) or Montreal (11.5%). Both Montreal (74.9%) and Vancouver (78.8%) had higher proportions of men who tested for another STBBI in the past 6 months than Toronto (67.4%). Vancouver had a higher proportion of men who used pre-exposure prophylaxis (PrEP) in the past 6 months (18.9%) than Toronto (11.1%) or Montreal (9.6%). Conclusion The three largest cities of Canada differed in HIV prevalence, STBBI testing and PrEP use among GBM. Our findings also suggest the need for scale-up of both PrEP and STI testing among GBM in Canada.

scholarly journals 1529. Sexually-Transmitted Infection Testing and Positivity among Adults Receiving HIV Pre-Exposure Prophylaxis within an Integrated Health Care Delivery System in the United States

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S765-S765
Author(s):  
Mark A Schmidt ◽  
John F Dickerson ◽  
Suzanne B Schmidt ◽  
Maureen O’Keeffe-Rosetti ◽  
Judy L Donald ◽  
...  
Keyword(s):  
Sexually Transmitted Infection ◽  
Care Delivery ◽  
The United States ◽  
Health Care Delivery System ◽  
Transmitted Infection ◽  
Record System ◽  
Sexually Transmitted ◽  
Sti Testing ◽  
Exposure Prophylaxis ◽  
The Impact

Abstract Background The goal of this project was to assess the frequency of sexually-transmitted infection (STI) testing and positivity among adult individuals initiating HIV Pre-Exposure Prophylaxis (PrEP) within Kaiser Permanente Northwest (KPNW). Methods We identified KPNW members, 18 years of age and older, who initiated PrEP (tenofovir+emtricitabine) between January 1, 2015 – December 31, 2018. Using data elements abstracted from the electronic health record system, we assessed demographic characteristics of those initiating PrEP and the rate of testing and positivity for HIV, chlamydia (CT) and gonorrhea (GC) and syphilis within a window around 120 days after PrEP initiation. Results Overall, 685 members initiated PrEP during our study period, 661 (96.5%) of whom were male. Mean and median ages were 38 and 36 years, respectively, with those 25-34 years of age comprising the highest proportion (241; 35.2%). The 460 PrEP initiators (67.2% of total) who continued use beyond 120 days were significantly older than those who discontinued use (39 vs. 36 years, p=0.0008). Among continuous users, 78.3% were tested for CT+GC and 83.9% were tested for syphilis roughly 120 days post-initiation, with positivity proportions of 6.9%, 6.7%, and 2.3%, respectively. Among those discontinuing, 39.6% were tested for CT+GC and 37.3% were tested for syphilis, with positivity proportions of 10.1%, 9.0%, and 2.4%, respectively. HIV testing was completed for 87.4% of continuous PrEP users and 40.9% of those who discontinued use; and we identified a total of three individuals who tested positive for HIV, all among the latter group. Manual chart review of these individuals confirmed that HIV exposure and infection occurred after PrEP discontinuation. Conclusion We found high rates of STI testing among individuals receiving PrEP, in accordance with recommendations. Our findings of a lower STI prevalence among PrEP users is encouraging, although further work is required to assess the impact of differential testing rates and age between those who continue and discontinue PrEP use as well as reasons for PrEP discontinuation. Regular testing remains an important part of comprehensive PrEP care management and should continue to be encouraged to identify and treat STI among those at high risk for disease. Disclosures All Authors: No reported disclosures

Sex club/party attendance and STI among men who have sex with men: results from an online survey in New York City

2019 ◽  
Vol 95 (8) ◽  
pp. 584-587 ◽  
Author(s):  
Étienne Meunier ◽  
Karolynn Siegel
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Online Survey ◽  
Multivariable Analysis ◽  
Biomedical Hiv Prevention ◽  
Sti Testing ◽  
Multivariable Analyses ◽  
Sex With Men ◽  
Exposure Prophylaxis

ObjectivePrior studies have shown that men who have sex with men (MSM) who attend sex clubs or parties are at higher risk for HIV and other STIs than those who do not. We sought to provide data about MSM who attend sex clubs/parties in New York City (NYC) in the era of biomedical HIV prevention.Methods: We conducted an online survey among MSM in NYC (n=766) in 2016–2017 and investigated differences between those who reported never attending a sex club/party (non-attendees 50.1%), those who had attended over a year ago (past attendees 18.0%) and those who attended in the prior year (recent attendees 30.1%). We also conducted multivariable analyses to explore associations with past-year STI diagnosis.Results: Recent attendees were not more likely to be HIV positive than non-attendees. Among participants never diagnosed with HIV, recent attendees were more likely to use pre-exposure prophylaxis (PrEP, 32.6%) than non-attendees (14.5%) and past attendees (18.8%; p<0.001). Recent attendees reported the highest numbers of recent sex partners, including partners with whom they had condomless anal sex. Significantly more recent attendees reported an STI diagnosis in the prior year (27.9%) compared with non-attendees (14.0%) and past attendees (16.5%; p<0.001). However, 13.8% of non-attendees and 11.5% of past attendees reported having never tested for STIs, significantly more than recent attendees (6.0%, p=0.010). Multivariable analysis showed recent attendees to have 2.42 times the odds (compared with non-attendees) of reporting past-year STI diagnosis (95% CI 1.52 to 3.87, p<0.001).ConclusionsCompared with those who had not done so, MSM who attended sex clubs/parties in NYC in the prior year were not only more likely to report past-year STI diagnoses but also more likely to report PrEP use or recent HIV/STI testing. Sexual health promotion among MSM who attend sex clubs/parties should address STI risk and prevention.

Estimating the impact of HIV combination prevention in men who have sex with men, the Bangkok MSM Cohort Study, Thailand

2020 ◽  
Vol 31 (7) ◽  
pp. 637-641
Author(s):  
Sarika Pattanasin ◽  
Betsy L Cadwell ◽  
Dawn K Smith ◽  
Wichuda Sukwicha ◽  
Philip A Mock ◽  
...  
Keyword(s):  
Condom Use ◽  
Hiv Infections ◽  
Substantial Impact ◽  
Combination Prevention ◽  
Hiv Epidemic ◽  
Immunodeficiency Virus ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
The Impact ◽  
Combined Interventions

In Thailand, pre-exposure prophylaxis (PrEP) is recommended for human immunodeficiency virus (HIV) prevention among at-risk men who have sex with men (MSM). We modeled the impact of PrEP and condom use as independent and combined interventions on the estimated number of HIV infections among a hypothetical population of 10,000 MSM in Bangkok, Thailand. Our model demonstrated a 92% (95% confidence interval 89.7, 94.2) reduction in HIV infections among Thai MSM who took daily PrEP and self-reported using condoms correctly and consistently (100% condom use). Increased use of PrEP and condoms likely would have a substantial impact on the HIV epidemic in Thailand.

scholarly journals Methods for county-level estimation of pre-exposure prophylaxis coverage and application to the U.S. Ending the HIV Epidemic jurisdictions

2020 ◽  
Vol 44 ◽  
pp. 16-30 ◽  
Author(s):  
Patrick S. Sullivan ◽  
Farah Mouhanna ◽  
Robertino Mera ◽  
Elizabeth Pembleton ◽  
Amanda D. Castel ◽  
...  
Keyword(s):  
County Level ◽  
Hiv Epidemic ◽  
Exposure Prophylaxis ◽  
The U.S

scholarly journals Factors Predicting Uptake of Sexually Transmitted Infections Testing among Men Who Have Sex with Men Who Are “Pre-Exposure Prophylaxis Tourists”—An Observational Prospective Cohort Study

2021 ◽  
Vol 18 (7) ◽  
pp. 3582
Author(s):  
Zixin Wang ◽  
Yuan Fang ◽  
Natthakhet Yaemim ◽  
Kai J. Jonas ◽  
Andrew Chidgey ◽  
...  
Keyword(s):  
Cohort Study ◽  
Service Providers ◽  
Risky Behaviors ◽  
Service Planning ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sti Testing ◽  
Sex With Men ◽  
Exposure Prophylaxis

The term “Pre-exposure prophylaxis (PrEP) tourists” refers to individuals who obtain PrEP in other countries and use it in their home countries. A prospective observational cohort study was conducted among a group of men who have sex with men (MSM) who obtained PrEP in private clinics in Thailand and used it in Hong Kong. Participants completed two web-based self-administered surveys when obtaining PrEP in Thailand and three months afterwards. Out of 110 participants at baseline, 67 completed the follow-up. The prevalence of sexually transmitted infection (STI) testing was 47.8% during the follow-up period. Eleven participants received an STI diagnosis, and seven of them were incident infections in the past three months. Participants who perceived a higher chance for STI infection (adjusted odds ratios (AOR): 1.90, 95% CI: 1.00, 3.75) and reported higher intention to take up STI testing at baseline (AOR: 1.62, 95% CI: 1.05, 2.50) were more likely to receive STI testing during the follow-up period. Baseline perceptions that service providers would think they were having risky behaviors because of PrEP use was negatively associated with the dependent variable (AOR: 0.51, 95% CI: 0.31, 0.86). Service planning and health promotion related to STI testing is needed for MSM “PrEP tourists”.

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