Vita W Jongen1, Elske Hoornenborg1, Mark Am van den Elshout1, Anders Boyd1,2, Hanne Ml Zimmermann1, Liza Coyer1, Udi Davidovich1,3, Peter L Anderson4, Henry Jc de Vries1,5, M Prins1,6, Maarten F Schim van der Loeff1,6. 1. Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands. 2. Stichting HIV Monitoring, Amsterdam, the Netherlands. 3. Department of Social Psychology, University of Amsterdam, Amsterdam, the Netherlands. 4. Department of Pharmaceutical Sciences, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA. 5. Amsterdam UMC, Department of Dermatology, Amsterdam institute for Infection and Immunity (AII), location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. 6. Amsterdam UMC, Internal Medicine, Amsterdam institute for Infection and Immunity (AII), University of Amsterdam, Amsterdam, The Netherlands.
Abstract
INTRODUCTION: Event-driven pre-exposure prophylaxis (edPrEP) with oral tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC) is highly effective for preventing HIV acquisition in men who have sex with men (MSM) and is preferred over daily PrEP by some MSM. However, it is largely unknown how well MSM adhere to edPrEP. We then aimed to assess PrEP protection during CAS among MSM using edPrEP and participating in the Amsterdam PrEP demonstration project (AMPrEP). METHODS: We analysed data from participants enrolled in AMPrEP who were taking edPrEP. We measured adherence through (1) a mobile application in which sexual behaviour and PrEP-use were recorded daily, (2) three-monthly self-completed questionnaires and (3) dried blood spot (DBS) samples collected around six, twelve and twenty-four months after PrEP initiation. We assessed the proportion of days with condomless anal sex (CAS) acts that were protected by PrEP, per partner type (i.e. steady partners, known casual partners, unknown casual partners), and the proportion of three-month periods during which PrEP was correctly used. Intracellular TFV-diphosphate (TFV-DP) concentrations were determined from DBS. Good adherence was defined as at least one tablet before and one tablet within 48 hours after a CAS act. RESULTS: Between 11 September 2015 and 6 October 2019, 182 of 376 MSM (48.4%) used edPrEP for at least one three-month period. Of the 8224 CAS days that were reported in the app during edPrEP-use, we observed good protection for most CAS days involving steady partners (n = 1625/2455, 66.9%), known casual partners (n = 3216/3472, 92.6%) and unknown casual partners (n = 2074/2297, 90.3%). Men reported consistently correct PrEP-use in 851 (81.4%) of the 1046 three-month periods of edPrEP-use. The median TFV-DP concentration was 591 fmol/sample (interquartile range = 270 to 896). CONCLUSIONS: Adherence to edPrEP was high as determined from the online app and questionnaire. DBS measurements were consistent with two to three tablets per week on average.
INTRODUCTION: Event-driven pre-exposure prophylaxis (edPrEP) with oral tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC) is highly effective for preventing HIV acquisition in men who have sex with men (MSM) and is preferred over daily PrEP by some MSM. However, it is largely unknown how well MSM adhere to edPrEP. We then aimed to assess PrEP protection during CAS among MSM using edPrEP and participating in the Amsterdam PrEP demonstration project (AMPrEP). METHODS: We analysed data from participants enrolled in AMPrEP who were taking edPrEP. We measured adherence through (1) a mobile application in which sexual behaviour and PrEP-use were recorded daily, (2) three-monthly self-completed questionnaires and (3) dried blood spot (DBS) samples collected around six, twelve and twenty-four months after PrEP initiation. We assessed the proportion of days with condomless anal sex (CAS) acts that were protected by PrEP, per partner type (i.e. steady partners, known casual partners, unknown casual partners), and the proportion of three-month periods during which PrEP was correctly used. Intracellular TFV-diphosphate (TFV-DP) concentrations were determined from DBS. Good adherence was defined as at least one tablet before and one tablet within 48 hours after a CAS act. RESULTS: Between 11 September 2015 and 6 October 2019, 182 of 376 MSM (48.4%) used edPrEP for at least one three-month period. Of the 8224 CAS days that were reported in the app during edPrEP-use, we observed good protection for most CAS days involving steady partners (n = 1625/2455, 66.9%), known casual partners (n = 3216/3472, 92.6%) and unknown casual partners (n = 2074/2297, 90.3%). Men reported consistently correct PrEP-use in 851 (81.4%) of the 1046 three-month periods of edPrEP-use. The median TFV-DP concentration was 591 fmol/sample (interquartile range = 270 to 896). CONCLUSIONS: Adherence to edPrEP was high as determined from the online app and questionnaire. DBS measurements were consistent with two to three tablets per week on average.
Authors: Amir M Mohareb; Joseph Larmarange; Arthur Y Kim; Patrick A Coffie; Menan Gérard Kouamé; Anders Boyd; Kenneth A Freedberg; Emily P Hyle Journal: Lancet HIV Date: 2022-07-08 Impact factor: 16.070
Authors: Jeffrey Cd Koole; Feline de la Court; Matthijs Ra Welkers; Kenneth Yap; Janneke E Stalenhoef; Suzanne Jurriaans; Henry Jc de Vries; Eline Lm Op de Coul; Maria Prins; Elske Hoornenborg Journal: Euro Surveill Date: 2022-04
Authors: Haoyi Wang; Oladipupo Shobowale; Chantal den Daas; Eline Op de Coul; Bouko Bakker; Aryanti Radyowijati; Koenraad Vermey; Arjan van Bijnen; Wim Zuilhof; Kai J Jonas Journal: Int J Environ Res Public Health Date: 2022-07-20 Impact factor: 4.614