Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
Department of Applied Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria.
J Acquir Immune Defic Syndr. 2018 Oct 1;79(2):186-194. doi: 10.1097/QAI.0000000000001791.
Daily pre-exposure prophylaxis and event-driven pre-exposure prophylaxis (PrEP) are efficacious in reducing HIV transmission among men who have sex with men (MSM). We analyzed baseline data from a PrEP demonstration project "Be-PrEP-ared" in Antwerp, Belgium, to understand preferences for daily PrEP or event-driven PrEP among MSM at high risk of HIV and factors influencing their initial choice.
Cross-sectional data from an open-label prospective cohort study, using mixed methods. Participants who preregistered online were screened for eligibility and tested for sexually transmitted infections (STIs). Eligible participants chose between daily PrEP and event-driven PrEP and reported on behavioral data through an electronic questionnaire. In-depth interviews were conducted with a selected subsample. Bivariate associations were examined between preferred PrEP regimens and sociodemographic factors, sexual behavior, and STIs at screening.
In total, 200 participants were enrolled between October 2015 and December 2016. Self-reported levels of sexual risk-taking before enrollment were high. STI screening revealed that 39.5% had at least 1 bacterial STI. At baseline, 76.5% of participants preferred daily PrEP and 23.5% event-driven PrEP. Feeling able to anticipate HIV risk was the most frequent reason for preferring event-driven PrEP. Regimen choice was associated with sexual risk-taking behavior in the past 3 months. Almost all participants (95.7%) considered it likely that they would change their dosing regimen the following year.
Event-driven PrEP was preferred by 23.5% of the participants, which better suits their preventive needs. Event-driven PrEP should be included in PrEP provision as a valuable alternative to daily PrEP for MSM at high risk of HIV.
每日暴露前预防和事件驱动的暴露前预防（PrEP）在减少男男性行为者（MSM）中的 HIV 传播方面是有效的。我们分析了比利时安特卫普 PrEP 示范项目“Be-PrEP-ared”的基线数据，以了解高 HIV 风险的 MSM 对每日 PrEP 或事件驱动 PrEP 的偏好，以及影响他们初始选择的因素。
这是一项开放标签前瞻性队列研究的横断面数据，采用混合方法。通过在线预注册的参与者接受了 HIV 感染和性传播感染（STI）的筛查。符合条件的参与者在每日 PrEP 和事件驱动 PrEP 之间进行选择，并通过电子问卷报告性行为数据。对选定的子样本进行了深入访谈。使用双变量关联分析来评估首选 PrEP 方案与社会人口统计学因素、性行为和筛查时的 STI 之间的关系。
共纳入 200 名参与者，纳入时间为 2015 年 10 月至 2016 年 12 月。入组前自我报告的性风险水平较高。STI 筛查显示，39.5%的参与者至少有一种细菌 STI。基线时，76.5%的参与者首选每日 PrEP，23.5%的参与者首选事件驱动 PrEP。能够预测 HIV 风险是选择事件驱动 PrEP 的最常见原因。方案选择与过去 3 个月的性行为风险有关。几乎所有参与者（95.7%）认为他们很可能会在明年改变他们的剂量方案。
23.5%的参与者首选事件驱动 PrEP，这更符合他们的预防需求。对于 HIV 高风险的 MSM，事件驱动 PrEP 应该作为每日 PrEP 的一种有价值的替代方案纳入 PrEP 服务中。
