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Adherence, sexual behavior and HIV/STI incidence among men who have sex with men (MSM) and transgender women (TGW) in the US PrEP demonstration (Demo) project
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[.......from Jules: successful project! - adherence high 80-86% - protective levels: >4-7 times per week taking pills - engagement good (both need improvement) - STI positivity high & persisted however - sexual behavior improved - HIV incident infections: relatively low incidence - ethnic & geographic disparities/housing instability]
Reported by Jules Levin
IAS 2015 Vancouver July 19-23
You Tube webcast:
https://www.youtube.com/watch?t=479&v=6SP3Hbe27lM3
Presented by Albert Liu3
A. Liu1,2, S. Cohen1,2, E. Vittinghoff2, P. Anderson3, S. Doblecki-Lewis4, O. Bacon2, W. Chege5, R. Elion6, S. Buchbinder1,2, M. Kolber4, Demo Project Study Group3
1San Francisco Department of Public Health, San Francisco, United States, 2University of California, San Francisco, United States, 3University of Colorado, Aurora, United States, 4University of Miami, Miami, United States, 5National Institutes of Health, Bethesda, United States, 6Whitman-Walker Health, Washington, DC, United States3
Program Abstract3
Background: Pre-exposure prophylaxis (PrEP) has demonstrated efficacy in reducing HIV acquisition in MSM and TGW. Little is known about adherence, sexual behavior, and HIV/STI incidence among those who elect to take PrEP in real-world settings.3
Methods: The Demo Project is the first US multi-site open-label study assessing PrEP delivery in municipal STD (San Francisco, Miami) and community-health (Washington, DC) clinics. HIV-uninfected MSM/TGW were offered 48 weeks of PrEP. Tenofovir-diphosphate levels were measured in dried blood spots (DBS) in a random sample of participants (pts). Correlates of adherence were assessed using multivariable logistic regression. Sexual behaviors, PrEP discontinuations, and HIV/STI incidence are described.
Conclusions: PrEP adherence was high and HIV incidence was low in this cohort at ongoing high sexual risk for HIV. STIs were common during PrEP use, highlighting the importance of screening and treatment. Strategies for counseling on appropriate PrEP discontinuation are warranted.
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