scholarly journals HIV Pre-exposure Prophylaxis Programs Incorporating Social Applications Can Reach At-Risk Men Who Have Sex With Men for Successful Linkage to Care in Missouri, USA

2017 ◽  
Vol 28 (3) ◽  
pp. 428-430 ◽  
Author(s):  
Rupa R. Patel ◽  
Laura C. Harrison ◽  
Viraj V. Patel ◽  
Philip A. Chan ◽  
Kenneth H. Mayer ◽  
...  
Keyword(s):  
At Risk ◽  
Linkage To Care ◽  
Sex With Men ◽  
Social Applications ◽  
Exposure Prophylaxis

scholarly journals Southern African guidelines for the safe use of pre-exposure prophylaxis in men who have sex with men who are at risk for HIV infection

2012 ◽  
Vol 13 (2) ◽  
Author(s):  
Southern African HIV Clinicians Society Consensus Committee
Keyword(s):  
At Risk ◽  
Renal Function ◽  
Hiv Prevention ◽  
Hepatitis B ◽  
Hiv Infection ◽  
Creatinine Clearance ◽  
Fixed Dose ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
Hiv Negative

Background. The use of oral antiretrovirals to prevent HIV infection among HIV-negative men who have sex with men (MSM) has been shown to be safe and efficacious. A large, randomised, placebo-controlled trial showed a 44% reduction in the incidence of HIV infection among MSM receiving a daily oral fixed-dose combination of tenofovir disoproxil fumarate and emtricitabine (Truvada) in combination with an HIV prevention package. Improved protection was seen with higher levels of adherence. Aim. The purpose of this guideline is to: (i) explain what pre-exposure prophylaxis (PrEP) is; (ii) outline current indications for its use; (iii) outline steps for appropriate client selection; and (iv) provide guidance for monitoring and maintaining clients on PrEP. Method. PrEP is indicated for HIV-negative MSM who are assessed to be at high risk for HIV acquisition and who are willing and motivated to use PrEP as part of a package of HIV prevention services (including condoms, lubrication, sexually transmitted infection (STI) management and risk reduction counselling). Recommendations. HIV testing, estimation of creatinine clearance and STI and hepatitis B screening are recommended as baseline investigations. Daily oral Truvada, along with adherence support, can then be prescribed for eligible MSM. PrEP should not be given to MSM with abnormal renal function, nor to clients who are unmotivated to use PrEP as part of an HIV prevention package; nor should it be commenced during an acute viral illness. Three-monthly follow-up visits to assess tolerance, renal function, adherence and ongoing eligibility is recommended. Six-monthly STI screens and annual creatinine levels to estimate creatinine clearance are recommended. Hepatitis B vaccination should be provided to susceptible clients. Gastro-intestinal symptoms and weight loss are common side-effects, mostly experienced for the first 4 - 8 weeks after initiating PrEP. There is a risk of the development of antiretroviral resistance among those with undiagnosed acute HIV infection during PrEP initiation and among those with sub-optimal adherence who become HIV infected while on PrEP. Risk compensation (increasing sexual behaviours that can result in exposure to HIV) while on PrEP may become a concern, and clinicians should continue to support MSM clients to continue to use condoms, condom-compatible lubrication and practice safer sex. Research is ongoing to assess optimum dosing regimens, potential long-term effects and alternative PrEP medications. Recommendations for the use of PrEP among other at-risk individuals, and the components of these recommendations, will be informed by future evidence. S Afr J HIV Med 2012;13(2):40-55.

Acceptability of a digital patient notification and linkage-to-care tool for French PrEPers (WeFLASH©): Key stakeholders' perspectives

2019 ◽  
Vol 30 (14) ◽  
pp. 1397-1407
Author(s):  
David Lessard ◽  
Alexandre Aslan ◽  
Jérémy Zeggagh ◽  
Stéphane Morel ◽  
David Michels ◽  
...  
Keyword(s):  
Linkage To Care ◽  
Epidemiological Data ◽  
Management Decision ◽  
Time Data ◽  
Transmitted Infection ◽  
Sti Prevention ◽  
Sexually Transmitted ◽  
Sex With Men ◽  
Access To Data ◽  
Exposure Prophylaxis

The objective of this study was to describe stakeholders’ perspectives on the acceptability of WeFLASH© (AADISS, Paris, France), a digital smartphone sexually transmitted infection (STI) patient notification (PN) tool to be launched among French HIV pre-exposure prophylaxis users (PrEPers). In Paris, Lyon, and Nice, we conducted 2-hour focus group discussions with PrEPers (n = 21) and community mediators (n = 10), and one-on-one interviews with PrEP-prescribing physicians (n = 5) and HIV/STI management decision-makers (n = 4). Recordings were transcribed. The analysis focused on perceived benefits and risks. Concerning benefits, participants mentioned that WeFLASH© could provide: improved PN and STI screening, by refining the notification of anonymous partners; customized linkage-to-care, by providing users with tailored information on care; and transferable epidemiological data, by filling a need for real-time data. Participants anticipated risks for: privacy and confidentiality and suggested specific security settings to protect users’ identity; sexual behavior and suggested game-like functions to improve the integration of the tool in sexual contexts; and fairness and emphasized the importance of making WeFLASH© accessible to all men who have sex with men. WeFLASH© could facilitate PN for an increasing proportion of anonymous partners met online, and empower users, including notified partners, on questions of confidentiality and consent, access to STI prevention and screening services, and access to data.

scholarly journals HIV Pre-exposure Prophylaxis (PrEP): Knowledge, attitudes and counseling practices among physicians in Germany – A cross-sectional survey

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250895
Author(s):  
Mary Katherine Sammons ◽  
Matthew Gaskins ◽  
Frank Kutscha ◽  
Alexander Nast ◽  
Ricardo Niklas Werner
Keyword(s):  
At Risk ◽  
Rural Areas ◽  
Knowledge Score ◽  
Cross Sectional Survey ◽  
Patient Centered ◽  
Cross Sectional ◽  
Related Services ◽  
Positive Attitudes ◽  
Sex With Men ◽  
Exposure Prophylaxis

Background German statutory health insurance began covering the costs associated with HIV PrEP in September 2019; however, to bill for PrEP services, physicians in Germany must either be certified as HIV-specialists according to a nationwide quality assurance agreement, or, if they are non-HIV-specialists, have completed substantial further training in HIV/PrEP care. Given the insufficient implementation of PrEP, the aim of our study was to explore the potential to increase the number of non-HIV-specialists providing PrEP-related services. Methods We conducted an anonymous survey among a random sample of internists, general practitioners, dermatologists and urologists throughout Germany using a self-developed questionnaire. We calculated a knowledge score and an attitudes score from individual items in these two domains. Both scores ranged from 0–20, with high values representing good knowledge or positive attitudes. We also asked participants about the proportion of PrEP advice they provided proactively to men who have sex with men (MSM) and trans-persons who met the criteria to be offered PrEP. Results 154 physicians completed the questionnaire. Self-assessed knowledge among HIV-specialists was greater than among non-HIV-specialists [Median knowledge score: 20.0 (IQR = 0.0) vs. 4.0 (IQR = 11.0), p<0.001]. Likewise, attitudes towards PrEP were more positive among HIV-specialists than non-HIV-specialists [Median attitudes score: 18.0 (IQR = 3.0) vs. 13.0 (IQR = 5.25), p<0.001]. The proportion of proactive advice on PrEP provided to at-risk MSM and trans-persons by HIV-specialists [Median: 30.0% (IQR = 63.5%)] was higher than that provided by non-HIV-specialists [Median: 0.0% (IQR = 11.3%), p<0.001]. However, the results of our multiple regression suggest the only independent predictor of proactive PrEP advice was the knowledge score, and not whether physicians were HIV-specialists or non-HIV-specialists. Conclusions These findings point to opportunities to improve PrEP implementation in individuals at risk of acquiring HIV. Targeted training, particularly for non-HIV-specialists, and the provision of patient-centered information material could help improve care, especially in rural areas.

scholarly journals The Pre-Exposure Prophylaxis Cascade in At-Risk Transgender Men Who Have Sex with Men in the United States

LGBT Health ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 116-124
Author(s):  
Sari L. Reisner ◽  
Chiara S. Moore ◽  
Andrew Asquith ◽  
Dana J. Pardee ◽  
Kenneth H. Mayer
Keyword(s):  
United States ◽  
At Risk ◽  
The United States ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
Transgender Men

scholarly journals Medication Adherence Among Men Who Have Sex with Men at Risk for HIV Infection in the United States: Implications for Pre-Exposure Prophylaxis Implementation

2014 ◽  
Vol 28 (12) ◽  
pp. 622-627 ◽  
Author(s):  
Albert Y. Liu ◽  
Nancy A. Hessol ◽  
Eric Vittinghoff ◽  
K. Rivet Amico ◽  
Elizabeth Kroboth ◽  
...  
Keyword(s):  
United States ◽  
At Risk ◽  
Medication Adherence ◽  
Hiv Infection ◽  
The United States ◽  
Sex With Men ◽  
Exposure Prophylaxis

scholarly journals Southern African guidelines on the safe use of pre-exposure prophylaxis in persons at risk of acquiring HIV-1 infection

2016 ◽  
Vol 17 (1) ◽  
Author(s):  
Linda-Gail Bekker ◽  
Kevin Rebe ◽  
Francois Venter ◽  
Gary Maartens ◽  
Michelle Moorhouse ◽  
...  
Keyword(s):  
At Risk ◽  
Treatment Guidelines ◽  
World Health ◽  
Combination Prevention ◽  
Transgender Persons ◽  
Sex With Men ◽  
Health Organization ◽  
Hiv Acquisition ◽  
Risk Of Hiv Acquisition ◽  
Exposure Prophylaxis

The Southern African HIV Clinicians Society published its first set of oral pre-exposure prophylaxis (PrEP) guidelines in June 2012 for men who have sex with men (MSM) who are at risk of HIV infection. With the flurry of data that has been generated in PrEP clinical research since the first guideline, it became evident that there was a need to revise and expand the PrEP guidelines with new evidence of safety and efficacy of PrEP in several populations, including MSM, transgender persons, heterosexual men and women, HIV-serodiscordant couples and people who inject drugs. This need is particularly relevant following the World Health Organization (WHO) Consolidated Treatment Guidelines released in September 2015. These guidelines advise that PrEP is a highly effective, safe, biomedical option for HIV prevention that can be incorporated with other combination prevention strategies in Southern Africa, given the high prevalence of HIV in the region. PrEP should be tailored to populations at highest risk of HIV acquisition, whilst further data from studies in the region accrue to guide optimal deployment to realise the greatest impact regionally. PrEP may be used intermittently during periods of perceived HIV acquisition risk, rather than continually and lifelong, as is the case with antiretroviral treatment. Recognition and accurate measurement of potential risk in individuals and populations also warrants discussion, but are not extensively covered in these guidelines.

scholarly journals How to Identify Potential Candidates for HIV Pre-Exposure Prophylaxis: An AI Algorithm Reusing Real-World Hospital Data

2021 ◽  
Author(s):  
Jean-Charles Duthe ◽  
Guillaume Bouzille ◽  
Emmanuelle Sylvestre ◽  
Emmanuel Chazard ◽  
Cedric Arvieux ◽  
...  
Keyword(s):  
At Risk ◽  
Hiv Infection ◽  
Hiv Risk ◽  
Hiv Infections ◽  
University Hospital ◽  
Hospital Data ◽  
Sexual Health Care ◽  
Patients At Risk ◽  
Sex With Men ◽  
Exposure Prophylaxis

HIV Pre-Exposure Prophylaxis (PrEP) is effective in Men who have Sex with Men (MSM), and is reimbursed by the social security in France. Yet, PrEP is underused due to the difficulty to identify people at risk of HIV infection outside the “sexual health” care path. We developed and validated an automated algorithm that re-uses Electronic Health Record (EHR) data available in eHOP, the Clinical Data Warehouse of Rennes University Hospital (France). Using machine learning methods, we developed five models to predict incident HIV infections with 162 variables that might be exploited to predict HIV risk using EHR data. We divided patients aged 18 or more having at least one hospital admission between 2013 and 2019 in two groups: cases (patients with known HIV infection in the study period) and controls (patients without known HIV infection and no PrEP in the study period, but with at least one HIV risk factor). Among the 624,708 admissions, we selected 156 cases (incident HIV infection) and 761 controls. The best performing model for identifying incident HIV infections was the combined model (LASSO, Random Forest, and Generalized Linear Model): AUC = 0.88 (95% CI: 0.8143-0.9619), specificity = 0.887, and sensitivity = 0.733 using the test dataset. The algorithm seems to efficiently identify patients at risk of HIV infection.

scholarly journals Health Care–Seeking Behaviors and Perceptions of Provider-Initiated Discussion of Pre-exposure Prophylaxis Among PrEP-Naïve HIV-Negative Men Who Have Sex With Men in Atlanta, Georgia

2020 ◽  
Vol 7 (5) ◽  
Author(s):  
Susanna L Trost ◽  
Udodirim N Onwubiko ◽  
Derick B Wilson ◽  
David P Holland ◽  
Allison T Chamberlain
Keyword(s):  
Health Care ◽  
At Risk ◽  
Health Care System ◽  
Health Care Seeking ◽  
Care Seeking ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
Health Care Seeking Behaviors ◽  
Hiv Negative ◽  
Care System

Abstract Background Given high rates of HIV among men who have sex with men (MSM) in the United States, there is a need to more effectively leverage the health care system to bolster promotion of pre-exposure prophylaxis (PrEP) to at-risk MSM. Methods Using data collected from a 2018 venue-based cross-sectional survey, we examined factors associated with health care–seeking behaviors, discussing PrEP with a provider, and barriers to PrEP uptake among MSM. Associations between outcomes and respondents’ sociodemographic characteristics and sexual behaviors were assessed using log binomial regression. Results Of 478 MSM, 247 (51%) were PrEP-naïve and HIV-negative. Although 85% of PrEP-naïve MSM reported visiting a health care provider in the past year, only 31% recalled having any provider discuss PrEP. The most frequently cited reasons for not taking PrEP were low perception of personal risk of acquiring HIV (37%) and not knowing enough about PrEP (35%). Those who saw a provider in the last year were less likely than those who did not to cite lack of knowledge as a barrier to use (prevalence rate, 0.66, 95% confidence interval, 0.45–0.96). Conclusions Despite the majority of PrEP-naïve MSM interfacing with the health care system, recollection of discussing PrEP with providers was limited. Increased efforts to equip providers with the tools to discuss PrEP and address pressing concerns with at-risk individuals may help improve PrEP uptake among priority populations.

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