Daily pre-exposure prophylaxis (PrEP) regimen of tenofovir/emtricitabine (TDF/FTC) tablet is the standard of care for HIV prevention in Thailand. Event-driven PrEP (ED-PrEP), taking two loading pills 2-24 h prior to sex and two doses afterward, is considered an alternative regimen. This pilot study aimed to describe accuracy of and retention in ED-PrEP use among Thai young men who have sex with men (YMSM). A cohort of YMSM aged 15-19 years at risk of HIV infection, defined as reporting irregular condom use or having an HIV-positive sexual partner, was enrolled. All participants were provided oral TDF/FTC, condoms, and the "Raincoat" mobile application, which reminds users when to administer ED-PrEP. Participants attended clinic visits at Months 1, 3, and 6 and followed up by phone at Months 2, 4, and 5. Proper use of ED-PrEP was reported in person-months. From August 2020 to July 2021, 36 YMSM with a median age of 18.7 (IQR, 17.5-19.4) years were enrolled. Thirty-two participants (88.9%, 95% CI: 73.9-96.9%) were retained at 6 months. No HIV incidence occurred during this study period. Of 197 person-months of follow-up, 69 (35%) involved sexual activity. In this group, 61% used ED-PrEP correctly. "Unplanned sexual activity" was the most commonly cited reason for incorrect use. YMSM who have infrequent sex had very high retention in ED-PrEP. However, about one-third of the sexually active period, ED-PrEP was not used correctly due to not taking the loading dose, suggesting that this regimen may not be suitable for unanticipated sexual activity.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1177/09564624221106527 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Event-driven PrEP beyond cisgender men who have sex with men.
Lancet HIV
January 2025
Division of Infectious Diseases, Hennepin Healthcare, Minneapolis, MN, USA; University of Minnesota, Minneapolis, MN, USA. Electronic address:
Despite advancements in existing antiretroviral-based prevention strategies, including daily oral, locally acting, and injectable options, there is a pressing need for more inclusive and flexible event-driven pre-exposure prophylaxis (PrEP) strategies for all. Event-driven or intermittent dosing of PrEP in populations beyond cisgender men who have sex with men would offer a promising alternative by fitting prevention into the diverse lifestyles of affected populations and thereby advancing health equity. Evidence from PrEP clinical trials, pharmacokinetic studies, modelling studies, and real-world observational research suggests that event-driven PrEP could be a flexible and inclusive option, yet optimal dosing has not been established across sex and gender spectrums.
View Article and Find Full Text PDFBarriers and missed opportunities in PrEP uptake, use and care among men who have sex with men with recent HIV infection in the Netherlands.
PLoS One
January 2025
Amsterdam University Medical Centers, Department of Infectious Diseases, Amsterdam Infection and Immunity Institute, University of Amsterdam, Amsterdam, The Netherlands.
Introduction: Oral pre-exposure prophylaxis (PrEP) prevents Human Immunodeficiency Virus (HIV) acquisition. In the Netherlands, PrEP is accessible through the national PrEP program (NPP) or general practitioners (GP). Still, some men who have sex with men (MSM) entering HIV care indicated having PrEP experience prior to diagnosis.
View Article and Find Full Text PDFFormulation development of dual-compartment topical inserts combining tenofovir alafenamide and elvitegravir for flexible on-demand HIV prevention.
J Control Release
January 2025
CONRAD, Eastern Virginia Medical School, Macon & Joan Brock Virginia Health Sciences at Old Dominion University, Norfolk, VA 23507, USA.
Pre-exposure prophylaxis (PrEP) has emerged as a prominent approach for the prevention of HIV infections. While the latest advances have resulted in effective oral and injectable product options, there are still gaps in on-demand, event-driven, topical products for HIV prevention that are safe and effective. Here we describe the formulation development of a dual-compartment topical insert containing tenofovir alafenamide fumarate (TAF) and elvitegravir (EVG) that may be administered when needed, vaginally or rectally, pre- or post-coitus, for flexible HIV prophylaxis.
View Article and Find Full Text PDFIncreasing event-driven HIV pre-exposure prophylaxis use among gay, bisexual and other men who have sex with men in Australia: results from behavioural surveillance 2019-2023.
J Int AIDS Soc
November 2024
Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia.
Introduction: HIV pre-exposure prophylaxis (PrEP) has been publicly available since 2018 in Australia as a daily regimen. In 2019, clinical guidelines were updated to support guidance on event-driven PrEP (ED-PrEP) use. We assessed trends in the PrEP dosing regimen by comparing daily PrEP use to ED-PrEP among cisgender gay, bisexual and other men who have sex with men (GBMSM).
View Article and Find Full Text PDFGene expression of tight junctions in foreskin is not affected by HIV pre-exposure prophylaxis.
Front Immunol
November 2024
Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.
Article Synopsis
- Tight junctions (TJs) act as barriers in cells and have numerous proteins associated with them, yet TJs in the male genital tract are not well-researched due to limited tissue availability.
- The study involved analyzing 132 TJ genes from foreskin tissue of men undergoing voluntary medical male circumcision as part of a larger HIV prevention trial in South Africa and Uganda, measuring the impact of various PrEP drugs on TJ protein expression.
- Results showed that 118 out of 132 TJ genes were highly expressed in foreskin tissue, and that the PrEP regimens tested did not alter TJ gene expression or protein levels, indicating the safety of these treatments in preventing HIV-1 transmission during sexual activity.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!