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Changes in sexual behavior among adolescent girls receiving long-acting injectable cabotegravir for HIV prevention: the HPTN 084-01 study
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AIDS 2024 July 20-26 Munich
B. Mirembe1, B. Hanscom2, Y. Jiao3, S. Delany-Moletlwe4, B. Siziba5, J. Ngo3, B. Kamira6, K. Hlahla5, N. Mgodi5, R. Nakalega6, E. Kabugho6, C. Nakabiito6, E. Hamilton7, S. Hosek8, L.-S. Chibanda5
Institutions
1MU-JHU Care LTD, CLlinic, Kampala, Uganda, 2Fred Hutchinson, Seattle, United States, 3Fred Hutchinson Statistical Center, Seattle, United States, 4University of Witwatersrand, Johannesburg, South Africa, 5University of Zimbabwe-CRTC, Harare, Zimbabwe, 6MU-JHU Care LTD, Kampala, Uganda, 7FHI 360, North Carolina, United States, 8University of Illinois, Chicago, United States
BACKGROUND: The HPTN 084-01 trial evaluated the safety, tolerability, and acceptability of long-acting injectable cabotegravir (CAB LA) for HIV prevention among adolescent girls in Africa. Adopting effective pre-exposure prophylaxis (PrEP) may reduce the concern for HIV acquisition but may lead to other riskier sexual behaviors. We sought to identify evidence of changes in sexual behavior following PrEP initiation within this cohort.
METHODS: HPTN 084-01 enrolled HIV negative adolescent girls aged 12-17 years from 3 sites in South Africa, Uganda, and Zimbabwe who reported sexual activity with a male in the last 12 months and were willing to provide assent with parent/guardian consent. Data on self-reported sexual behavior, namely
1) use of a condom at last vaginal sex and
2) number of sexual partners in past month was assessed at study weeks 0, 4, 5, 9, 17, 25 and 33 by Computer Assisted Self-administered Interview.
Change in frequency of condomless vaginal sex (CVS) and number of sexual partners over time was assessed through generalized estimating equations.
RESULTS: In total, 55 adolescents were enrolled with a median age 16 years, a median of 2 (IQR 1-4) episodes of vaginal sex in the past month, and 22% reporting transactional sex. At week 0, median number of male partners in the past month was 1 (range 1-30), and 29% had more than one male partner while mean episodes of CVS in the past month was 1 (sd 2.1), and 47% reported CVS. Between weeks 0 and 33, a modest decline in number of sexual partners was observed though not statistically significant; average change -0.3 partners (95% CI -0.61, 0.06, p= 0.11). We observed a decrease in the number of episodes of CVS between weeks 0 and 33; average change -0.6 episodes (95% CI -1.03, -0.14, p= 0.0093).
CONCLUSIONS: In this cohort of African adolescent girls initiating CAB LA for PrEP, we also observed declines in other risk behaviors. This is consistent with other PrEP studies and confirms that HIV prevention trial participation provides benefits beyond access to medical interventions like PrEP.
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