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Patterns of sex and PrEP in Bangkok MSM (HPTN 067/ADAPT Study)
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Reported by Jules Levon
IAS Vancouver 2015 July 19-23
Tareerat Chemnasiri, Anchalee Varangrat, K. Rivet Amico, Supaporn Chaikummao, Anupong Chitwarakorn, Bonnie J. Dye, Robert M. Grant, Timothy H. Holtz, and the HPTN 067/ADAPT Study Team
WEBCAST: https://www.youtube.com/watch?v=ZFqAQazqp3Y
In summary, participants reported that the daily dose is the easiest regimen without ability of planning for sex, but there WERE concerns about long-term impacts and affordability.
We found that NON-DAILY PrEP would be another choice for those MSM who have infrequent sex events.
Candidates for non-daily dosing could include MSM having relatively infrequent sexual intercourse activity (less than once a week), capacity for planning for sex, and ability to take a post sex dose.
In conclusions, participants preferred to have different PrEP regimen options.
Participants noted THAT regimen confusion was one of THE barriers to PrEP adherence, therefore PrEP adherence counseling is needed for ANY PrEP user.
And we need to give more information about PrEP to reduce stigma, and FOSTER MORE EFFECTIVE PrEP use.
For more information, see poster link attached below
IAS: Facilitators and barriers affecting PrEP adherence among Thai men who have sex with men in the HPTN 067/ADAPT study - (07/27/15)
In August 2013 and March 2014, we collected data from 38 THAI participants who joined the ADAPT study IN BANGKOK.
We conducted 6 focus group discussions with 32 participants and 6 key-informant interviews with 6 participants, 2 per each study arm after they completed 34 weeks of study follow-up.
After that, we double coded Thai transcripts and analyzed the data. Grounded theory and content analysis were used in this study COMPONENT.
AMONG THE Total of 38 participants, the age range was 21 to 50 years old and THE median age was 30 years.
Seventy-one percent of participants were full-time employed, eighty-six percent completed college, and all of them reported never BEING married.
We assessed patterns of sex in 3 different arms with pros and cons of each regimen.
For THE daily regimen, participants reported THAT this regimen worked well if they had this pattern of sex: having frequent sex eventS, A preference not to plan for sex, having no control over planning for sex with sexual partners, and self-perceived of having high risk for HIV.
There WERE pros and cons about THE daily regimen, such as easy-to-take as it can be taken with daily vitamins, no need to plan for sex, no need to carry the TABLETS, and no need to disclose about PrEP use.
But there were concerns about long-term impact and side effects and fears about being seen as HIV-infected PERSON. Some reported it was difficult to use if they DIDNŐT have sex that much. Long-term TABLET-taking, routine change, TABLET fatigue, and affordability were also reported.
Participants in THE time-driven regimen reported THAT this regimen was optimal for this pattern of sex: participants with infrequent sex eventS, and inability to plan sex or having no control over planning for sex with sexual partners.
The PROs about this regimen WERE: fewer doses which meant less concerns about side effects; ABILITY TO choose the day to take 2 TABLETS a week, NO need to plan for sex, AND just keepING a few TABLETS with them for THE POST sex dose.
On the other hand, the participants reported difficulty in linking routine activity with 2 TABLET-talking days, confusion about THE regimen because it is quite complicated, the need to carry TABLETS and hide them from others, and they noted that planning for sex made sex no longer enjoyable.
Participants in THE event-driven regimen reported THAT this regimen worked well if participants had this pattern of sex: infrequent sex events, and ability to plan sex or having control over planning for sex with sexual partners.
The PRO about this regimen was fewer doses REQUIRED.
On the other hand, it WAS difficult for PARTICIPANTS to plan for sex, to carry TABLETS, and to hide them from others. It WAS confusing to count THE TABLET-taking time by the hour, and the regimen WAS complicated or difficult for them to follow.
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