scholarly journals Reliability and Validity of a Free Oral Pre-exposure Prophylaxis (PrEP) Adherence Questionnaire Among Patients with Sexually Transmitted Infection and Without HIV Infection in Shanghai

2020 ◽  
Author(s):  
Xiaoyue Yu ◽  
Chen Xu ◽  
Yang Ni ◽  
Ruijie Chang ◽  
Huwen Wang ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Hiv Infection ◽  
Sexually Transmitted Infection ◽  
Roc Curve ◽  
Content Validity ◽  
Item Analysis ◽  
Reliability And Validity ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Exposure Prophylaxis

Abstract Objective: In this study, we aimed to evaluate the validity and reliability of the free oral pre-exposure prophylaxis (PrEP) adherence questionnaire among patients with sexually transmitted infection who do not have HIV infection in Shanghai. Methods: We conducted a cross-sectional study among 816 patients from sexually transmitted infection (STI) clinics in Shanghai. The questionnaire included self-reported demographic characteristics, items on adherence to free oral pre-exposure prophylaxis (PrEP), and PrEP uptake behavior measurement. Item analysis was carried out by calculating the critical ratio and item-total correlations. Internal consistency and split-half reliability were measured to assess reliability. Content validity, construct validity, convergent validity and discriminant validity were measured to assess validity. We conducted logistic regression with receiver operating characteristic (ROC) curve analysis to assess the predictive value of the adherence questionnaire for PrEP uptake behavior. Results: All items were considered acceptable in the item analysis (P<0.05). The questionnaire had a Cronbach’s alpha of 0.757 and split-half reliability of 0.633. The scale-level content validity index (CVI) was 0.938 and the item-level CVI of each item ranged from 0.750 to 1. In exploratory factor analysis, we introduced a four-factor model accounting for 79.838% of the aggregate variance with all factors loading more than 0.4, which was validated in confirmatory factor analysis (c2=47.1, degrees of freedom=14, root mean square error of approximation=0.078). According to regression analysis, adding PrEP adherence questionnaire scores contributed to prediction of PrEP uptake behavior (P<0.001). The maximum area under the ROC curve was 0.778 (95% confidence interval: 0.739–0.817), corresponding to a cutoff score of 9.Conclusion: The PrEP adherence questionnaire generally has acceptable reliability and validity. This questionnaire can be used as a tool to evaluate PrEP adherence in patients with STI who do not have HIV infection.

scholarly journals Pre-Exposure Prophylaxis (PrEP) Adherence Questionnaire: Psychometric Validation among Sexually Transmitted Infection Patients in China

2021 ◽  
Vol 18 (20) ◽  
pp. 10980
Author(s):  
Xiaoyue Yu ◽  
Chen Xu ◽  
Yang Ni ◽  
Ruijie Chang ◽  
Huwen Wang ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Sexually Transmitted Infection ◽  
Roc Curve ◽  
Item Analysis ◽  
Psychometric Validation ◽  
Roc Curve Analysis ◽  
Transmitted Infection ◽  
Cross Sectional ◽  
Sexually Transmitted ◽  
Exposure Prophylaxis

Background: Ensuring adherence guarantees the efficacy of pre-exposure prophylaxis (PrEP). Methods: We conducted a cross-sectional study among 816 sexually transmitted infection (STI) patients in Shanghai. The questionnaire included self-reported demographic characteristics, self-administered items on adherence to free oral PrEP, and PrEP uptake behavior measurement. We conducted item analysis, reliability analysis, validity analysis and receiver operating characteristic (ROC) curve analysis. Results: Not all items were considered acceptable in the item analysis. The questionnaire had a McDonald’s ω coefficient of 0.847. The scale-level content validity index (CVI) was 0.938 and the item-level CVI of each item ranged from 0.750 to 1. In exploratory factor analysis, we introduced a four-factor model accounting for 79.838% of the aggregate variance, which was validated in confirmatory factor analysis. Adding PrEP adherence questionnaire scores contributed to prediction of PrEP uptake behavior (p < 0.001) in regression analysis. The maximum area under the ROC curve was 0.778 (95% IC: 0.739–0.817). Conclusion: The PrEP adherence questionnaire presented psychometric validation among STI patients.

scholarly journals Randomized Controlled Pilot Study of Antiretrovirals and a Behavioral Intervention for Persons With Acute HIV Infection: Opportunity for Interrupting Transmission

2018 ◽  
Vol 6 (1) ◽  
Author(s):  
William C Miller ◽  
Sarah E Rutstein ◽  
Sam Phiri ◽  
Gift Kamanga ◽  
Dominic Nsona ◽  
...  
Keyword(s):  
Pilot Study ◽  
Hiv Infection ◽  
Behavioral Intervention ◽  
Sexually Transmitted Infection ◽  
Health Benefit ◽  
Acute Hiv Infection ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Randomized Controlled ◽  
Acute Hiv

Abstract Background Persons with acute HIV infection (AHI) have heightened transmission risk. We evaluated potential transmission reduction using behavioral and biomedical interventions in a randomized controlled pilot study in Malawi. Methods Persons were randomized 1:2:2 to standard counseling (SC), 5-session behavioral intervention (BI), or behavioral intervention plus 12 weeks of antiretrovirals (ARVs; BIA). All were followed for 26–52 weeks and, regardless of arm, referred for treatment according to Malawi-ARV guidelines. Participants were asked to refer partners for testing. Results Among 46 persons (9 SC, 18 BI, 19 BIA), the average age was 28; 61% were male. The median viral load (VL) was 5.9 log copies/mL at enrollment. 67% (10/15) of BIA participants were suppressed (&lt;1000 copies/mL) at week 12 vs 25% BI and 50% SC (P = .07). Although the mean number of reported condomless sexual acts in the past week decreased from baseline across all arms (1.5 vs 0.3 acts), 36% experienced incident sexually transmitted infection by 52 weeks (12% SC, 28% BI, 18% BIA). Forty-one percent (19/46) of participants referred partners (44% SC, 44% BI, 37% BIA); 15 of the partners were HIV-infected. Conclusions Diagnosis of AHI facilitates behavioral and biomedical risk reduction strategies during a high-transmission period that begins years before people are typically identified and started on ARVs. Sexually transmitted infection incidence in this cohort suggests ongoing risk behaviors, reinforcing the importance of early intervention with ARVs to reduce transmission. Early diagnosis coupled with standard AHI counseling and early ARV referral quickly suppresses viremia, may effectively change behavior, and could have tremendous public health benefit in reducing onward transmission.

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

scholarly journals Sexually transmitted infection diagnoses, sexualised drug use and associations with pre-exposure prophylaxis use among men who have sex with men in the UK

2020 ◽  
Vol 31 (3) ◽  
pp. 254-263
Author(s):  
Matthew P Hibbert ◽  
Caroline E Brett ◽  
Lorna A Porcellato ◽  
Vivian D Hope
Keyword(s):  
Drug Use ◽  
Sexually Transmitted Infection ◽  
Transmitted Infection ◽  
Cross Sectional ◽  
Sexually Transmitted ◽  
Factors Associated ◽  
Hiv Test ◽  
Condomless Anal Intercourse ◽  
Sex With Men ◽  
Exposure Prophylaxis

Previous research has focused on acceptability of pre-exposure prophylaxis (PrEP) use, but few community-based studies have been conducted regarding actual use, and PrEP use in the context of sexualised drug use remains understudied. A national online cross-sectional study recruited men who have sex with men (MSM) via social media (April–June 2018). Multivariable logistic regression was used to investigate factors associated with PrEP use. Bivariate analyses compared engaging in condomless anal intercourse (CAI) under the influence of specific drugs and recent sexually transmitted infection (STI) diagnoses (past 12 months) between MSM taking PrEP and those not. Overall, 6% (99/1581) MSM reported current PrEP use. Factors associated with PrEP use were increasing age, recent genitourinary medicine (GUM) attendance (95% versus 45%, aOR = 6.25, 95%CI 2.05, 19.03), an HIV test in the past three months (89% versus 23%, aOR = 14.22, 95%CI 6.76, 29.90), and recent engagement in chemsex (21% versus 4%, aOR = 3.56, 95%CI 1.78, 7.11). MSM taking PrEP were more likely to have had an STI diagnosis (42% versus 8%), most commonly chlamydia (26% versus 3%) and gonorrhoea (25% versus 4%). Considering the elevated levels of self-reported STI diagnoses among those on PrEP, there was a high level of engagement with sexual health services, which may help reduce onward STI transmission.

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