Goodman-Meza David, Beymer Matthew R, Kofron Ryan M, Amico K Rivet, Psaros Christina, Bushman Lane R, Anderson Peter L, Bolan Robert, Jordan Wilbert C, Rooney James F, Wohl Amy R, Landovitz Raphael J
a Division of Infectious Diseases, David Geffen School of Medicine at UCLA , Los Angeles , CA , USA.
b Health and Mental Health Services, Los Angeles LGBT Center , Los Angeles , CA , USA.
AIDS Care. 2019 Oct;31(10):1228-1233. doi: 10.1080/09540121.2019.1595523. Epub 2019 Mar 20.
PrEP's potential benefit for men who have sex with men (MSM) who use stimulants may be limited by adherence or prescriber willingness to recommend PrEP due to concerns of non-compliance. Using data from PATH-PrEP, a 48-week study evaluating PrEP for MSM in Los Angeles, we modeled an interaction between stimulant use and condomless sex with multiple partners (CAS-MP) on prevention-effective dried blood spot tenofovir-diphosphate concentrations. At week 4, participants reporting stimulant use and CAS-MP had a decreased odds of prevention-effective adherence compared to non-stimulant use and non-CAS-MP (AOR 0.15, 95% CI 0.04-0.57). From week 4-48, participants reporting stimulant use and CAS-MP had increased odds of prevention-effective adherence (AOR 1.06 per week, 95%CI 1.01-1.12). Participants reporting CAS-MP without stimulant use had no significant change in prevention-effective adherence (AOR 0.99 per week, 95%CI 0.96-1.02). Stimulant use moderated the association of CAS-MP on prevention-effective PrEP adherence over time.
对于使用兴奋剂的男男性行为者（MSM）而言，暴露前预防（PrEP）的潜在益处可能会受到依从性的限制，或者由于担心不依从，开处方者不愿推荐PrEP。利用来自PATH-PrEP（一项在洛杉矶评估男男性行为者PrEP的为期48周的研究）的数据，我们模拟了兴奋剂使用与多个性伴侣无保护性行为（CAS-MP）之间的相互作用对预防有效的干血斑二磷酸替诺福韦浓度的影响。在第4周时，报告使用兴奋剂和进行CAS-MP的参与者与未使用兴奋剂和未进行CAS-MP的参与者相比，预防有效依从性的几率降低（调整后比值比[AOR]为0.15，95%置信区间[CI]为0.04-0.57）。从第4周到第48周，报告使用兴奋剂和进行CAS-MP的参与者预防有效依从性的几率增加（每周AOR为1.06，95%CI为1.01-1.12）。报告进行CAS-MP但未使用兴奋剂的参与者预防有效依从性没有显著变化（每周AOR为0.99，95%CI为0.96-1.02）。随着时间的推移，兴奋剂的使用调节了CAS-MP与预防有效PrEP依从性之间的关联。
