HIV pre-exposure prophylaxis in men who have sex with men and transgender women: a secondary analysis of a phase 3 randomised controlled efficacy trial

Abstract Background Pre-exposure prophylaxis (PrEP) is not widely available in China. Previous studies reported low awareness and inconclusive findings on the acceptability of PrEP among Chinese men who have sex with men (MSM). Methods We conducted a secondary analysis of an online national survey comparing preferences for oral and long-acting injectable PrEP among MSM and identifying correlates of preferences. The study did not collect detailed information about partner types that may influence negotiated safety and PrEP uptake. Results Nine-hundred and seventy-nine men from the larger sample of 1045 men responded to the PrEP survey questions. Most men (81.9%) had never heard of PrEP, but reported interest in using PrEP. More participants chose injectable PrEP (36.3%) as their preferred formulation than oral PrEP (24.6%). Men who had at least two HIV tests (adjusted OR = 1.36, 95%CI 1.04, 1.78) more commonly preferred injectable PrEP. Conclusion Our findings may help inform PrEP messaging in areas where PrEP has yet to be scaled up.

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Individual-level characteristics associated with oral HIV test acceptability among Peruvian men who have sex with men and transgender women: a cross-sectional study

Sexually Transmitted Infections ◽

10.1136/sextrans-2017-053388 ◽

2018 ◽

Vol 94 (7) ◽

pp. 528-533 ◽

Cited By ~ 4

Author(s):

Juan A Flores ◽

Brandon Brown ◽

Segundo R León ◽

Hugo Sánchez ◽

Jerome T Galea

Keyword(s):

Health Centre ◽

Secondary Analysis ◽

Prevalence Ratio ◽

Transgender Women ◽

Cross Sectional ◽

Individual Level ◽

Factors Associated ◽

Hiv Test ◽

Sex With Men ◽

The Individual

ObjectivesPeruvian men who have sex with men (MSM) and transgender women (TGW) are highly vulnerable to HIV infection (HIV), but stigma, access issues and fear of venipuncture hamper testing. The oral HIV test—which uses oral fluids and provides results in 20 minutes—could reduce these barriers. The objective of this study was to determine the acceptability of the oral HIV test and the individual-level factors associated with its acceptability among MSM and TGW.MethodsWe conducted a cross-sectional secondary analysis among Peruvian MSM and TGW attending a community-based health centre between February 2012 and February 2013 to determine the individual-level factors associated with oral HIV test acceptability.ResultsOf 334 participants, 88% were MSM and 12% TGW. Overall, 85% of participants indicated their acceptability of the oral HIV test. Acceptability was higher in MSM than TGW (85.7% vs 80.0%) but this difference was not significant. Factors associated with acceptability in MSM were: tertiary or higher education (prevalence ratio (PR)=1.18, 95% CI 1.06 to 1.32 and PR=1.16, 95% CI 1.03 to 1.30, respectively); sex with drug use (PR=1.19, 95% CI 1.05 to 1.36); believing that HIV is transmitted by saliva (PR=1.20, 95% CI 1.08 to 1.33); and potential use of the oral test at home (PR=1.56, 95% CI 1.32 to 1.85). The only factor associated with lower acceptability was having had first anal intercourse between 14 and 19 years of age (PR=0.89, 95% CI 0.80 to 0.98).ConclusionsWe identified the individual factors associated with oral HIV test acceptability among Peruvian MSM and TGW. Expanded use of the oral HIV test to increase testing rates among Peruvian MSM and TGW is recommended.Trial registration numberNCT01387412, post-results.

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High pre-exposure prophylaxis uptake and early adherence among men who have sex with men and transgender women at risk for HIV Infection: the PrEP Brasil demonstration project

Journal of the International AIDS Society ◽

10.7448/ias.20.1.21472 ◽

2017 ◽

Vol 20 (1) ◽

pp. 21472 ◽

Cited By ~ 49

Author(s):

Brenda Hoagland ◽

Ronaldo I. Moreira ◽

Raquel B. De Boni ◽

Esper G. Kallas ◽

José Valdez Madruga ◽

...

Keyword(s):

At Risk ◽

Hiv Infection ◽

Transgender Women ◽

Demonstration Project ◽

Sex With Men ◽

Exposure Prophylaxis

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“I wish to remain HIV negative”: Pre-exposure prophylaxis adherence and persistence in transgender women and men who have sex with men in coastal Kenya

PLoS ONE ◽

10.1371/journal.pone.0244226 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0244226

Author(s):

Makobu Kimani ◽

Elise M. van der Elst ◽

Oscar Chirro ◽

Elizabeth Wahome ◽

Fauz Ibrahim ◽

...

Keyword(s):

Risk Behaviour ◽

Healthcare Services ◽

Transgender Women ◽

Situational Factors ◽

Sub Saharan Africa ◽

Sexual Risk Behaviour ◽

Sub Saharan ◽

Sex With Men ◽

Hiv Acquisition ◽

Exposure Prophylaxis

Background Transgender women (TGW) and men who have sex with men (MSM) in sub-Saharan Africa have high HIV acquisition risks and can benefit from daily pre-exposure prophylaxis (PrEP). We assessed PrEP adherence by measuring tenofovir-diphosphate (TFV-DP) levels and explore motives for PrEP persistence in TGW and MSM. Methods Participants were enrolled in a one-year PrEP programme and made quarterly visits irrespective of whether they were still using PrEP. At their month 6 visit, participants provided a dried blood spot to test for TFV-DP levels; protective levels were defined as those compatible with ≥4 pills per week (700–1249 fmol/punch). Before TFV-DP levels were available, a sub-set of these participants were invited for an in-depth interview (IDI). Semi-structured IDI topic guides were used to explore motives to uptake, adhere to, and discontinue PrEP. IDI data were analyzed thematically. Results Fifty-three participants (42 MSM and 11 TGW) were enrolled. At month 6, 11 (20.7%) participants (8 MSM and 3 TGW) were lost to follow up or stopped taking PrEP. Any TFV-DP was detected in 62.5% (5/8) of TGW vs. 14.7% of MSM (5/34, p = 0.01). Protective levels were detected in 37.5% of TGW (3/8), but not in any MSM. Nineteen IDI were conducted with 7 TGW and 9 MSM on PrEP, and 1 TGW and 2 MSM off PrEP. Unplanned or frequent risky sexual risk behaviour were the main motives for PrEP uptake. Among participants on PrEP, TGW had a more complete understanding of the benefits of PrEP. Inconsistent PrEP use was attributed to situational factors. Motives to discontinue PrEP included negative reactions from partners and stigmatizing healthcare services. Conclusion While MSM evinced greater adherence challenges in this PrEP programme, almost 40% of TGW were protected by PrEP. Given high HIV incidences in TGW these findings hold promise for TGW PrEP programming in the region.

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Prepared for PrEP: Preferences for HIV pre-exposure prophylaxis among Chinese men who have sex with men in an online national survey

10.21203/rs.2.11005/v3 ◽

2019 ◽

Author(s):

Wenting Huang ◽

Dan Wu ◽

Jason O. Ong ◽

M. Kumi Smith ◽

Fan Yang ◽

...

Keyword(s):

National Survey ◽

Secondary Analysis ◽

Chinese Men ◽

Sex With Men ◽

Partner Types ◽

Long Acting ◽

Negotiated Safety ◽

Exposure Prophylaxis ◽

Larger Sample ◽

Oral Prep

Abstract Background: Pre-exposure prophylaxis (PrEP) is not widely available in China. Previous studies reported low awareness and inconclusive findings on the acceptability of PrEP among Chinese men who have sex with men (MSM). Methods: We conducted a secondary analysis of an online national survey comparing preferences for oral and long-acting injectable PrEP among MSM and identifying correlates of preferences. The study did not collect detailed information about partner types that may influence negotiated safety and PrEP uptake. Results: Nine-hundred and seventy-nine men from the larger sample of 1045 men responded to the PrEP survey questions. Most men (81.9%) had never heard of PrEP, but reported interest in using PrEP. More participants chose injectable PrEP (36.3%) as their preferred formulation than oral PrEP (24.6%). Men who had at least two HIV tests (adjusted OR = 1.36, 95%CI 1.04, 1.78) more commonly preferred injectable PrEP. Conclusion: Our findings may help inform PrEP messaging in areas where PrEP has yet to be scaled up.

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