scholarly journals Piloting a partially self-financed mode of human immunodeficiency virus pre-exposure prophylaxis delivery for men who have sex with men in Hong Kong

2019 ◽  
Author(s):  
SS Lee ◽  
TH Kwan ◽  
NS Wong ◽  
Krystal CK Lee ◽  
Denise PC Chan ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hong Kong ◽  
Immunodeficiency Virus ◽  
Sex With Men ◽  
Exposure Prophylaxis

scholarly journals Rectal Microbiome Alterations Associated With Oral Human Immunodeficiency Virus Pre-Exposure Prophylaxis

2019 ◽  
Vol 6 (11) ◽  
Author(s):  
Jennifer A Fulcher ◽  
Fan Li ◽  
Ryan R Cook ◽  
Sara Zabih ◽  
Alexander Louie ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Lasso Regression ◽  
Long Term Effects ◽  
Cross Sectional ◽  
Microbiome Composition ◽  
Immunodeficiency Virus ◽  
Sex With Men ◽  
Selection Operator ◽  
Exposure Prophylaxis ◽  
Sectional Analysis

Abstract Background Oral daily tenofovir (TFV) disoproxil fumarate/emtricitabine (TDF/FTC) for human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) is highly effective for HIVprevention, yet long-term effects are not fully understood. We investigated the effects of PrEP on the rectal microbiome in a cohort of men who have sex with men (MSM). Methods This cross-sectional analysis included HIV-negative MSM either on PrEP (n = 37) or not (n = 37) selected from an ongoing cohort using propensity score matching. Rectal swabs were used to examine microbiome composition using 16S ribosomal ribonucleic acid gene sequencing, and associations between PrEP use and microbiota abundance were examined. Hair specimens were used to quantify TFV and FTC exposure over the past 6 weeks on a subset of participants (n = 15). Results Pre-exposure prophylaxis use was associated with a significant increase in Streptococcus abundance (adjusted P = .015). Similar associations were identified using least absolute shrinkage and selection operator (LASSO) regression, confirming the increase in Streptococcus and also showing increased Mitsuokella, Fusobacterium, and decreased Escherichia/Shigella. Increased Fusobacterium was significantly associated with increasing TFV exposure. Conclusions Oral TDF/FTC for PrEP is associated with rectal microbiome changes compared to well matched controls, specifically increased Streptococcus and Fusobacterium abundance. This study highlights the need for future investigations of the role of microbiome changes on HIV susceptibility and effectiveness of PrEP.

scholarly journals Prescribing of Human Immunodeficiency Virus (HIV) Pre-exposure Prophylaxis by HIV Medical Providers in the United States, 2013–2014

2017 ◽  
Vol 4 (1) ◽  
Author(s):  
John Weiser ◽  
Shikha Garg ◽  
Linda Beer ◽  
Jacek Skarbinski
Keyword(s):  
Human Immunodeficiency Virus ◽  
Prevalence Ratio ◽  
The United States ◽  
Hiv Care ◽  
Care Providers ◽  
Persons Who Inject Drugs ◽  
Provider Characteristics ◽  
Immunodeficiency Virus ◽  
Sex With Men ◽  
Exposure Prophylaxis

Abstract Background Clinical trials have demonstrated the effectiveness of human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) for reducing HIV acquisition. Understanding how HIV care providers are prescribing PrEP is necessary to ensure success of this prevention strategy. Methods During 2013–2014, we surveyed US HIV care providers who also provided care to HIV-negative patients. We estimated percentages who had prescribed PrEP and assessed associations between provider characteristics and PrEP prescribing. Results An estimated 26% (95% confidence interval [CI], 20–31) had ever prescribed PrEP. Of these, 74% (95% CI, 61–87) prescribed for men who have sex with men (MSM), 30% (95% CI, 21–39) for women who have sex with men, 23% (95% CI, 9–37) for men who have sex with women, 23% (95% CI, 15–30) for uninfected partners in HIV-discordant couples trying to conceive, and 1% (95% CI, 0–2) for persons who inject drugs. The following provider characteristics were significantly associated with having prescribed PrEP: male vs female (32% vs 16%; adjusted prevalence ratio [aPR], 1.5; 95% CI, 1.0–2.2), lesbian/gay/bisexual vs heterosexual orientation (50% vs 21%; aPR, 2.0; 95% CI, 1.3–2.9), and HIV caseload (>200, 51–200, and ≤50 patients, 39%, 29%, and 14%, respectively; >200 vs ≤50 patients, aPR 2.4, 95% CI 1.1–5.2, and 51–200 vs ≤50 patients, aPR 2.2, 95% CI 1.2–4.0). Conclusions In 2013–2014, one quarter of HIV care providers reported having prescribed PrEP, most commonly for MSM and rarely for persons who inject drugs. Lesbian/gay/bisexual providers and male providers were more likely than others to have prescribed PrEP. Additional efforts may enable more providers to prescribe PrEP to underserved clients needing the service.

scholarly journals Implementation and Access to Pre-exposure Prophylaxis for Human Immunodeficiency Virus by Men Who Have Sex With Men in Europe

2021 ◽  
Vol 8 ◽  
Author(s):  
Bruno Sepodes ◽  
João Rocha ◽  
Jorge Batista ◽  
Maria-Eduardo Figueira ◽  
František Dráfi ◽  
...  
Keyword(s):  
Public Health ◽  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Public Health Intervention ◽  
The United States ◽  
World Health ◽  
European Economic Area ◽  
Immunodeficiency Virus ◽  
Sex With Men ◽  
Exposure Prophylaxis

Pre-exposure prophylaxis (PrEP) is a significant public health intervention with proven efficacy and safety in the prevention of human immunodeficiency virus (HIV) infection, which has taken a considerable amount of time to reach Europe in relation to their transatlantic counterparts, namely, the United States of America (USA). There, it is perceived as being an essential prevention tool to be integrated within existing medical, behavioral and structural interventions in place for the management and containment of HIV infection in men who have sex with men (MSM). In a region such as Europe, with approximately double the USA population, it is estimated that not even 10% have proper access to PrEP, and given the lack of coordination with healthcare, taking PrEP has to be at their own expense. Here, we identify the reasons behind the 4-year lag in the approval of PrEP in the European Union/European Economic Area (and Europe in general) and explore the efficacy and effectiveness of PrEP needed to be confirmed with some implementation or demonstration studies conducted in the region. Independent of the data gathered, access of MSM to PrEP is far from ideal in Europe and much still needs to be done. The demonstration of the cost-effectiveness of PrEP alongside other social and behavioral factors needs to be addressed, while the clear populations within MSM that will benefit from this intervention are properly identified and make use of the latest recommendations of the World Health Organization that consider not only daily PrEP but also event-driven PrEP. The momentum for the proper implementation of PrEP in the EU is not lost, and with the existence of generics and even new formulations, there is a renewed opportunity for unleashing the public health benefits arising from this pharmacological tool with other interventions in place (e.g., condoms, testing, and counseling).

scholarly journals Grindr Users Take More Risks, but Are More Open to Human Immunodeficiency Virus (HIV) Pre-exposure Prophylaxis: Could This Dating App Provide a Platform for HIV Prevention Outreach?

2019 ◽  
Vol 71 (7) ◽  
pp. e135-e140 ◽  
Author(s):  
Martin Hoenigl ◽  
Susan J Little ◽  
David Grelotti ◽  
Britt Skaathun ◽  
Gabriel A Wagner ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Risk Behavior ◽  
Hiv Infections ◽  
The United States ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Immunodeficiency Virus ◽  
Prevention Behavior ◽  
Sex With Men ◽  
Exposure Prophylaxis

Abstract Background Technology has changed the way that men who have sex with men (MSM) seek sex. More than 60% of MSM in the United States use the internet and/or smartphone-based geospatial networking apps to find sex partners. We correlated use of the most popular app (Grindr) with sexual risk and prevention behavior among MSM. Methods A nested cohort study was conducted between September 2018 and June 2019 among MSM receiving community-based human immunodeficiency virus (HIV) and sexually transmitted infection (STI) screening in central San Diego. During the testing encounter, participants were surveyed for demographics, substance use, risk behavior (previous 3 months), HIV pre-exposure prophylaxis (PrEP) use, and Grindr usage. Participants who tested negative for HIV and who were not on PrEP were offered immediate PrEP. Results The study included 1256 MSM, 1090 of whom (86.8%) were not taking PrEP. Overall, 580 of 1256 (46%) participants indicated that they used Grindr in the previous 7 days. Grindr users reported significantly higher risk behavior (greater number of male partners and condomless sex) and were more likely to test positive for chlamydia or gonorrhea (8.6% vs 4.7% of nonusers; P = .005). Grindr users were also more likely to be on PrEP (18.7% vs 8.7% of nonusers; P < .001) and had fewer newly diagnosed HIV infections (9 vs 26 among nonusers; P = .014). Grindr users were also nearly twice as likely as nonusers to initiate PrEP (24.6% vs 14%; P < .001). Conclusions Given the higher risk behavior and greater acceptance of PrEP among MSM who used Grindr, Grindr may provide a useful platform to promote HIV and STI testing and increase PrEP uptake.

scholarly journals Knowledge, Attitudes and Practices Regarding Pre-Exposure Prophylaxis (PrEP) in a Sample of Italian Men Who Have SEX with MEN (MSM)

2021 ◽  
Vol 18 (9) ◽  
pp. 4772
Author(s):  
Gianluca Voglino ◽  
Maria Rosaria Gualano ◽  
Stefano Rousset ◽  
Pietro Forghieri ◽  
Isabella Fraire ◽  
...  
Keyword(s):  
Online Survey ◽  
Immune Deficiency Syndrome ◽  
Deficiency Syndrome ◽  
Attitudes And Practices ◽  
Immunodeficiency Virus ◽  
Sex With Men ◽  
Prep Awareness ◽  
Exposure Prophylaxis ◽  
The Cost ◽  
Knowledge Attitudes And Practices

Background: Pre-exposure prophylaxis (PrEP) is suitable for high human immunodeficiency virus (HIV)-infection risk people, foremost among whom are males who have sex with other males (MSM). This study evaluated knowledge, attitudes and practices regarding PrEP in a sample of Italian MSM, in order to hypothesize strategies to implement PrEP awareness and use. No previous study has assessed this issue; Methods: An online survey was given to an opportunistic sample of Italian MSM. The questionnaire investigated sexual behaviour and habits, HIV/acquired immune deficiency syndrome (AIDS) knowledge and PrEP awareness, attitudes and practices. Univariable and multivariable logistic regressions were conducted to identify factors associated with PrEP knowledge; Results: A total of 196 MSM participated in this survey. Overall data showed that 87.2% of participants knew what PrEP is, but only 7.5% have ever used it. The main reason for not using PrEP was the cost of the therapy (26.9%). The principal source of PrEP information was the Internet (68.4%). Being regularly tested for HIV was significantly associated with PrEP knowledge (adjusted odds ratio (AdjOR) = 3.16; confidence interval (CI) = 1.06–9.29); Conclusions: Knowledge regarding PrEP was well established, but PrEP use was not equally widespread. It is necessary to improve research on PrEP usage in order to PrEP access to be granted.

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