Abstract
Daily and event-driven PrEP are both efficacious in reducing the risk for HIV infection. However, the practice of event-driven PrEP (edPrEP) is less well studied, in particular when provided as an alternative to daily PrEP. We studied regimen preferences and switches, and sexually transmitted infection (STI) incidence.
Methods
We analysed pooled data from two prospective cohort studies among MSM: Be-PrEP-ared, Belgium and AMPrEP, the Netherlands. In both projects, participants could choose between daily and edPrEP at three-monthly study visits, when they were also screened for sexually transmitted infections including hepatitis C (HCV). We assessed the proportion choosing each regimen, and the determinants of choosing edPrEP at baseline. Additionally, we compared the incidence rates (IRs) of HCV, syphilis and chlamydia or gonorrhoea between regimens using Poisson regression. The study period was from 3 August 2015 until 24 September 2018.
Results and discussion
We included 571 MSM, of whom 148 (25.9%) chose edPrEP at baseline. 31.7% of participants switched regimen at least once. After 28 months, 23.5% used edPrEP. Older participants (adjusted odds ratio (aOR) = 1.38 per 10 years, 95% confidence interval (CI) = 1.15 to 1.64) and those unemployed (aOR = 1.68, 95% CI = 1.03 to 1.75) were more likely to initially choose edPrEP. IR of HCV and syphilis did not differ between regimens, but the IR of chlamydia/gonorrhoea was higher among daily users (adjusted incidence rate ratio = 1.61, 95% CI = 1.35 to 1.94).
Conclusions
A quarter of participants chose edPrEP at baseline and at 28 months this proportion was similar. Although the IR of HCV and syphilis were similar in the two regimens, the lower incidence of chlamydia and gonorrhoea among edPrEP users may suggest that less frequent STI testing of this group could be considered.
Original language | English |
---|---|
Article number | e25768 |
Number of pages | 7 |
Journal | Journal of the International AIDS Society |
Volume | 24 |
Issue number | 8 |
DOIs | |
Publication status | Published - 1 Aug 2021 |
Keywords
- HIV Infections/epidemiology
- HIV prevention & control
- Homosexuality, Male
- Humans
- Male
- Pre-Exposure Prophylaxis
- Prospective Studies
- Sexual Behavior
- Sexual and Gender Minorities
- event-driven PrEP
- men who have sex with men
- sexually transmitted infections
- syphilis
Access to Document
Other files and links
Cite this
- APA
- Author
- BIBTEX
- Harvard
- Standard
- RIS
- Vancouver
}
In: Journal of the International AIDS Society, Vol. 24, No. 8, e25768, 01.08.2021.
Research output: Contribution to journal › Article › Academic › peer-review
TY - JOUR
T1 - Choosing event-driven and daily HIV pre-exposure prophylaxis - data from two European PrEP demonstration projects among men who have sex with men
AU - Jongen, V.W.
AU - Reyniers, T.
AU - Ypma, Z.M.H.
AU - Schim van der Loeff, M.F.
AU - Davidovich, U.
AU - Zimmermann, H.M.L.
AU - Coyer, L.
AU - van den Elshout, M.A.M.
AU - de Vries, H.J.C.
AU - Wouters, K.
AU - Smekens, T.
AU - Vuylsteke, B.
AU - Prins, M.
AU - Laga, M.
AU - Hoornenborg, E.
N1 - Funding Information: The study medication for the Be‐PrEP‐ared study of Antwerp and the Amsterdam PrEP study was provided by Gilead Sciences based on unconditional grants. EH received advisory board fees from Gilead Sciences and speaker fees from Janssen‐Cilag, both paid to her institute. UD received unrestricted research grants and speaker’s fees from Gilead Sciences, paid to his institute. HJCdV received grants from Medigene, and advisory board and speaker fees from Gilead Sciences, Medigene, Abbvie, Janssen‐Cilag and Willpharma, paid to his institute. MP received unrestricted research grants and speaker’s fees from Gilead Sciences, Roche, Abbvie and MSD, paid to her institute. MSvdL served on an Advisory Board of MSD, paid to his institute. All other authors declare no competing interest. Funding Information: The Tale of Two Cities project was funded by ZonMW (grant number: 522008009). TR is a postdoctoral fellow of the Research Foundation ? Flanders. The Be-PrEP-ared study was funded by the Applied Biomedical Research (TBM) Program of the Belgium Research Agency (IWT). CT/NG diagnostic kits for Real Time PCR used during the Be-PrEP-ared study were donated by Abbott. The AMPrEP project received funding as part of the H-Team Initiative from ZonMw (grant number 522002003), the National Institute for Public Health and the Environment and GGD research funds. The H-Team initiative is being supported by the Aidsfonds Netherlands (grant number 2013169), Stichting Amsterdam Diner Foundation, Gilead Sciences Europe Ltd (grant number PA-HIV-PREP-16-0024), Gilead Sciences (protocol numbers CO-NL-276-4222, CO-US-276-1712), Janssen Pharmaceuticals (reference number PHNL/JAN/0714/0005b/1912fde), M.A.C AIDS Fund and ViiV Healthcare (PO numbers 3000268822, 3000747780). We thank all Be-PrEP-ared and AMPrEP participants, the members of H-team and the members of the advisory boards and community engagement groups of Be-PrEP-ared and AMPrEP. We acknowledge the invaluable support provided by Dominique Loomans to the data management of this study. Lastly, we thank Jozefien Buyze and Irith De Baetselier. The Tale of Two Cities project was funded by ZonMW (grant number: 522008009). TR is a postdoctoral fellow of the Research Foundation ? Flanders. The Be-PrEP-ared study was funded by the Applied Biomedical Research (TBM) Program of the Belgium Research Agency (IWT). CT/NG diagnostic kits for Real Time PCR used during the Be-PrEP-ared study were donated by Abbott. The AMPrEP project received funding as part of the H-Team Initiative from ZonMw (grant number 522002003), the National Institute for Public Health and the Environment and GGD research funds. The H-Team initiative is being supported by the Aidsfonds Netherlands (grant number 2013169), Stichting Amsterdam Diner Foundation, Gilead Sciences Europe Ltd (grant number PA-HIV-PREP-16-0024), Gilead Sciences (protocol numbers CO-NL-276-4222, CO-US-276-1712), Janssen Pharmaceuticals (reference number PHNL/JAN/0714/0005b/1912fde), M.A.C AIDS Fund and ViiV Healthcare (PO numbers 3000268822, 3000747780). Funding Information: The Tale of Two Cities project was funded by ZonMW (grant number: 522008009). TR is a postdoctoral fellow of the Research Foundation – Flanders. The Be‐PrEP‐ared study was funded by the Applied Biomedical Research (TBM) Program of the Belgium Research Agency (IWT). CT/NG diagnostic kits for Real Time PCR used during the Be‐PrEP‐ared study were donated by Abbott. The AMPrEP project received funding as part of the H‐Team Initiative from ZonMw (grant number 522002003), the National Institute for Public Health and the Environment and GGD research funds. The H‐Team initiative is being supported by the Aidsfonds Netherlands (grant number 2013169), Stichting Amsterdam Diner Foundation, Gilead Sciences Europe Ltd (grant number PA‐HIV‐PREP‐16‐0024), Gilead Sciences (protocol numbers CO‐NL‐276‐4222, CO‐US‐276‐1712), Janssen Pharmaceuticals (reference number PHNL/JAN/0714/0005b/1912fde), M.A.C AIDS Fund and ViiV Healthcare (PO numbers 3000268822, 3000747780). Publisher Copyright: © 2021 The Authors. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of International AIDS Society
PY - 2021/8/1
Y1 - 2021/8/1
N2 - IntroductionDaily and event-driven PrEP are both efficacious in reducing the risk for HIV infection. However, the practice of event-driven PrEP (edPrEP) is less well studied, in particular when provided as an alternative to daily PrEP. We studied regimen preferences and switches, and sexually transmitted infection (STI) incidence.MethodsWe analysed pooled data from two prospective cohort studies among MSM: Be-PrEP-ared, Belgium and AMPrEP, the Netherlands. In both projects, participants could choose between daily and edPrEP at three-monthly study visits, when they were also screened for sexually transmitted infections including hepatitis C (HCV). We assessed the proportion choosing each regimen, and the determinants of choosing edPrEP at baseline. Additionally, we compared the incidence rates (IRs) of HCV, syphilis and chlamydia or gonorrhoea between regimens using Poisson regression. The study period was from 3 August 2015 until 24 September 2018.Results and discussionWe included 571 MSM, of whom 148 (25.9%) chose edPrEP at baseline. 31.7% of participants switched regimen at least once. After 28 months, 23.5% used edPrEP. Older participants (adjusted odds ratio (aOR) = 1.38 per 10 years, 95% confidence interval (CI) = 1.15 to 1.64) and those unemployed (aOR = 1.68, 95% CI = 1.03 to 1.75) were more likely to initially choose edPrEP. IR of HCV and syphilis did not differ between regimens, but the IR of chlamydia/gonorrhoea was higher among daily users (adjusted incidence rate ratio = 1.61, 95% CI = 1.35 to 1.94).ConclusionsA quarter of participants chose edPrEP at baseline and at 28 months this proportion was similar. Although the IR of HCV and syphilis were similar in the two regimens, the lower incidence of chlamydia and gonorrhoea among edPrEP users may suggest that less frequent STI testing of this group could be considered.
AB - IntroductionDaily and event-driven PrEP are both efficacious in reducing the risk for HIV infection. However, the practice of event-driven PrEP (edPrEP) is less well studied, in particular when provided as an alternative to daily PrEP. We studied regimen preferences and switches, and sexually transmitted infection (STI) incidence.MethodsWe analysed pooled data from two prospective cohort studies among MSM: Be-PrEP-ared, Belgium and AMPrEP, the Netherlands. In both projects, participants could choose between daily and edPrEP at three-monthly study visits, when they were also screened for sexually transmitted infections including hepatitis C (HCV). We assessed the proportion choosing each regimen, and the determinants of choosing edPrEP at baseline. Additionally, we compared the incidence rates (IRs) of HCV, syphilis and chlamydia or gonorrhoea between regimens using Poisson regression. The study period was from 3 August 2015 until 24 September 2018.Results and discussionWe included 571 MSM, of whom 148 (25.9%) chose edPrEP at baseline. 31.7% of participants switched regimen at least once. After 28 months, 23.5% used edPrEP. Older participants (adjusted odds ratio (aOR) = 1.38 per 10 years, 95% confidence interval (CI) = 1.15 to 1.64) and those unemployed (aOR = 1.68, 95% CI = 1.03 to 1.75) were more likely to initially choose edPrEP. IR of HCV and syphilis did not differ between regimens, but the IR of chlamydia/gonorrhoea was higher among daily users (adjusted incidence rate ratio = 1.61, 95% CI = 1.35 to 1.94).ConclusionsA quarter of participants chose edPrEP at baseline and at 28 months this proportion was similar. Although the IR of HCV and syphilis were similar in the two regimens, the lower incidence of chlamydia and gonorrhoea among edPrEP users may suggest that less frequent STI testing of this group could be considered.
KW - HIV Infections/epidemiology
KW - HIV prevention & control
KW - Homosexuality, Male
KW - Humans
KW - Male
KW - Pre-Exposure Prophylaxis
KW - Prospective Studies
KW - Sexual Behavior
KW - Sexual and Gender Minorities
KW - event-driven PrEP
KW - men who have sex with men
KW - sexually transmitted infections
KW - syphilis
UR - http://www.scopus.com/inward/record.url?scp=85114110023&partnerID=8YFLogxK
U2 - https://doi.org/10.1002/jia2.25768
DO - https://doi.org/10.1002/jia2.25768
M3 - Article
C2 - 34382345
SN - 1758-2652
VL - 24
JO - Journal of the International AIDS Society
JF - Journal of the International AIDS Society
IS - 8
M1 - e25768
ER -