scholarly journals PrEP Nonadherence, White Coat Dosing, and HIV Risk Among a Cohort of MSM

2020 ◽  
Vol 7 (8) ◽  
Author(s):  
Cheríe S Blair ◽  
Matthew R Beymer ◽  
Ryan M Kofron ◽  
Robert K Bolan ◽  
Wilbert C Jordan ◽  
...  
Keyword(s):  
Hiv Risk ◽  
White Coat ◽  
Drug Concentrations ◽  
Optimal Drug ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
Preceding Study

Abstract Among a cohort of men who have sex with men in a pre-exposure prophylaxis (PrEP) adherence trial, syphilis requiring treatment was associated with white coat dosing (increased PrEP adherence immediately preceding study visits) when compared with participants with optimal drug concentrations. The findings highlight the need for identifying and reducing barriers to PrEP adherence.

Factors influencing uptake of pre-exposure prophylaxis: some qualitative insights from an intervention study of men who have sex with men in China

Sexual Health ◽  
2018 ◽  
Vol 15 (1) ◽  
pp. 39 ◽  
Author(s):  
Chunxing Liu ◽  
Yingying Ding ◽  
Zhen Ning ◽  
Meiyang Gao ◽  
Xing Liu ◽  
...  
Keyword(s):  
Hiv Risk ◽  
Intervention Study ◽  
Implementation Strategies ◽  
Self Assessment ◽  
Risk Beliefs ◽  
Group Data ◽  
Prep Implementation ◽  
Substantial Risk ◽  
Sex With Men ◽  
Exposure Prophylaxis

Background: Pre-exposure prophylaxis (PrEP) is a biomedical approach for preventing the acquisition of HIV in populations at substantial risk for HIV. However, its uptake among men who have sex with men (MSM) is low in China. The study aimed to identify factors that might influence MSM’s uptake and use of PrEP. Methods: In-depth interviews were conducted with 32 self-identified MSM from a PrEP intervention study evaluating daily oral tenofovir disoproxil fumarate (TDF) to prevent HIV infection. Of these men, 11 were presently using the ‘TDF’ group; 8 from the ‘change-over’ group (i.e. initially used PrEP but subsequently quitted); and 13 from the non-user group. Data were analysed using thematic approach. Results: Perception of low HIV risk, mistrust of the national PrEP program, and concerns of side effects were the main reasons for not wanting to use PrEP. Also, lack of main sexual partner’s support, difficulties in adhering to the daily TDF regimen, and the inconvenient schedules in securing the medicine were the major reasons for not wanting to use or quitting the use of PrEP. On the other hand, perceived high HIV risk, beliefs in efficacy of PrEP, and worries of transmitting HIV to families were the major motives for PrEP uptake. Conclusions: Findings suggest that PrEP implementation strategies should first address issues including but not limited to accurate self-assessment of HIV risk, mistrust and limited knowledge about medical trials and PrEP, and ease of accessing PrEP.

Impact of HIV risk perception on both pre-exposure prophylaxis and condom use

2019 ◽  
pp. 135910531988392
Author(s):  
Marion Di Ciaccio ◽  
Luis Sagaon-Teyssier ◽  
Christel Protière ◽  
Mohamed Mimi ◽  
Marie Suzan-Monti ◽  
...  
Keyword(s):  
Risk Perception ◽  
High Risk ◽  
Condom Use ◽  
Hiv Risk ◽  
Health Behaviours ◽  
Two Dimensions ◽  
Hiv Risk Perception ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
Trajectory Modelling

Risk perception is one of the several important factors impacting sexual health behaviours. This study investigated the evolution of HIV risk perception on pre-exposure prophylaxis adherence and condom use in men who have sex with men at high risk of HIV and associated factors. Group-based trajectory modelling helped in identifying patterns of risk perception, pre-exposure prophylaxis adherence and condom use over time. The association between the former and the latter two dimensions was then investigated. An estimated 61 per cent ( p < 0.001) of participants perceiving low risk and 100 per cent ( p < 0.001) of those perceiving high risk had systematic pre-exposure prophylaxis adherence, while an estimated 49 per cent ( p < 0.001) and 99.8 per cent ( p < 0.001), respectively, reported low-level condom use.

Structural Stigma Affects Access to Pre- and Post-exposure Prophylaxis and HIV Risk among Men Who Have Sex with Men (MSM) in the United States

2014 ◽  
Vol 30 (S1) ◽  
pp. A22-A23 ◽  
Author(s):  
Catherine Oldenburg ◽  
Amaya Perez-Brumer ◽  
Mark Hatzenbuehler ◽  
Douglas Krakower ◽  
David Novak ◽  
...  
Keyword(s):  
United States ◽  
Hiv Risk ◽  
The United States ◽  
Post Exposure Prophylaxis ◽  
Post Exposure ◽  
Sex With Men ◽  
Exposure Prophylaxis

Self-Perception of HIV Risk and Candidacy for Pre-Exposure Prophylaxis Among Men Who Have Sex with Men Testing for HIV at Commercial Sex Venues in New York City

LGBT Health ◽  
2014 ◽  
Vol 1 (3) ◽  
pp. 218-224 ◽  
Author(s):  
Timothy Gallagher ◽  
Lauren Link ◽  
Michael Ramos ◽  
Edward Bottger ◽  
Judith Aberg ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Hiv Risk ◽  
York City ◽  
Commercial Sex ◽  
Self Perception ◽  
Sex With Men ◽  
Exposure Prophylaxis

Developing targeted HIV risk predictors for young black men who have sex with men: a two-city comparative study

2020 ◽  
Vol 31 (4) ◽  
pp. 335-344
Author(s):  
Anthony C Nguyen ◽  
Lindsay E Young ◽  
Matthew R Beymer ◽  
Sze-Chuan Suen
Keyword(s):  
United States ◽  
Los Angeles ◽  
Black Men ◽  
Hiv Risk ◽  
The United States ◽  
Risk Indicator ◽  
Screening Guidelines ◽  
Control And Prevention ◽  
Sex With Men ◽  
Exposure Prophylaxis

HIV burden in the United States is geographically and demographically heterogeneous. While efforts over the last few decades have reduced HIV incidence, young black men who have sex with men (YBMSM) account for a significant portion of new HIV diagnoses compared to any other race and age group. The Centers for Disease Control and Prevention has allocated funding to help reduce HIV in the YBMSM community; however, their recommended screening/treatment criteria do not emphasize demographic specificity. To better guide more applicable screening guidelines specifically for YBMSM, we examine demographic, behavioral, sexual network, and biological predictors of HIV status among YBMSM in two demographically distinct cities with high HIV burden in the United States: Chicago, IL and Los Angeles, CA. We perform multivariable logistic regressions to identify predictors of HIV in these populations. We found that having a history of syphilis was the only statistically significant predictor across both cities despite inclusion of other characteristics previously shown to be associated with HIV among YBMSM. Syphilis history could be a powerful HIV risk indicator for YBMSM and, therefore, should be integrated into clinical screening practices for critical biomedical prevention options like HIV pre-exposure prophylaxis.

scholarly journals Creating a Theoretically Grounded Gaming App to Increase Adherence to Pre-Exposure Prophylaxis: Lessons From the Development of the Viral Combat Mobile Phone Game (Preprint)

2018 ◽  
Author(s):  
Laura Whiteley ◽  
Leandro Mena ◽  
Lacey K Craker ◽  
Meredith Garver Healy ◽  
Larry K Brown
Keyword(s):  
Hiv Risk ◽  
Future Orientation ◽  
The United States ◽  
Care Providers ◽  
Behavioral Skills ◽  
Game Development ◽  
Care Clinic ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
Gaming Intervention

BACKGROUND In the United States, young minority men who have sex with men (MSM) are most likely to become infected with HIV. The use of antiretroviral medications to reduce the risk of acquiring HIV infection (pre-exposure prophylaxis, PrEP) is an efficacious and promising prevention strategy. There have been significant advances regarding PrEP, including the definitive demonstration that PrEP reduces HIV acquisition and the development of clinical prescribing guidelines. Despite these promising events, the practical implementation of PrEP can be challenging. Data show that PrEP’s safety and effectiveness could be greatly compromised by suboptimal adherence to treatment, and there is concern about the potential for an increase in HIV risk behavior among PrEP users. Due to these challenges, the prescribing of PrEP should be accompanied by behavioral interventions to promote adherence. OBJECTIVE This study aimed to develop an immersive, action-oriented iPhone gaming intervention to improve motivation for adherence to PrEP. METHODS Game development was guided by social learning theory, taking into consideration the perspectives of young adult MSM who are taking PrEP. A total of 20 young men who have sex with men (YMSM; aged 18-35 years) were recruited from a sexually transmitted infection (STI), HIV testing, and PrEP care clinic in Jackson, Mississippi, between October 2016 and June 2017. They participated in qualitative interviews guided by the information-motivation-behavioral skills (IMB) model of behavior change. The mean age of participants was 26 years, and all the participants identified as male. Acceptability of the game was assessed with the Client Service Questionnaire and session evaluation form. RESULTS A number of themes emerged that informed game development. YMSM taking PrEP desired informational game content that included new and comprehensive details about the effectiveness of PrEP, details about PrEP as it relates to doctors’ visits, and general information about STIs other than HIV. Motivational themes that emerged were the desire for enhancement of future orientation; reinforcement of positive influences from partners, parents, and friends; collaboration with health care providers; decreasing stigma; and a focus on personal relevance of PrEP-related medical care. Behavioral skills themes centered around self-efficacy and strategies for adherence to PrEP and self-care. CONCLUSIONS We utilized youth feedback, IMB, and agile software development to create a multilevel, immersive, action-oriented iPhone gaming intervention to improve motivation for adherence to PrEP. There is a dearth of gaming interventions for persons on PrEP. This study is a significant step in working toward the development and testing of an iPhone gaming intervention to decrease HIV risk and promote adherence to PrEP for YMSM.

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.

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