Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Division of Infectious Diseases, Department of Medicine, Taipei City Hospital Renai Branch, Taipei, Taiwan.
J Int AIDS Soc. 2023 Sep;26(9):e26163. doi: 10.1002/jia2.26163.
INTRODUCTION: While various antiretrovirals have been studied as potential candidates for long-acting pre-exposure prophylaxis (PrEP), the bimonthly injectable cabotegravir-the first long-acting form of PrEP-was approved in 2021. Event-driven (ED) PrEP has been the most prevalent dosing regimen among gay, bisexual and other men who have sex with men (GBMSM) in Taiwan, providing a unique setting to observe the preferences for long-acting PrEP in a community where the daily regimen is not the mainstream method. This study aimed to determine the preferences for the different forms and dosing intervals of long-acting PrEP that are currently in the development pipeline. METHODS: We conducted a survey in 2021 by convenience sampling the users of social networking applications for GBMSM in Taiwan. Our survey included questions on sexual behaviours, current PrEP regimens and the preferences for potential candidates of long-acting PrEP, such as implants, intramuscular and subcutaneous injections. We compared the Likert-scale preference ratings for potential long-acting options, and conducted logistic regression analysis to examine the factors associated with a preference for bimonthly intramuscular injections (2M IM) over ED and daily PrEP regimens, respectively. RESULTS: A total of 1728 responses were eligible for analysis. Three percent of respondents (n = 52) were daily PrEP users; 11.5% (n = 198) were ED PrEP users. When not considering cost, current PrEP users-regardless of their original dosing regimen-were most likely to express preferences for monthly oral PrEP, followed by a 6-month subcutaneous injectable (6M SC) and 2M IM. However, among non-current PrEP users, monthly oral PrEP was the most preferred form, followed by ED, daily oral and 6M SC injectable. Multivariable logistic regression revealed that current daily users, those willing to take PrEP in the next 6 months and those with more sex partners in the last 12 months had a significant correlation with preferences for the 2M IM injectable over the ED PrEP. CONCLUSIONS: The monthly oral form was the most preferable long-acting PrEP among GBMSM in Taiwan. Current daily PrEP users preferred the 2M IM injectable over the ED PrEP, which made the 2M IM injectable a potential alternative. Further studies should focus on how the cost and delivery affect PrEP preferences and their actual uptake.
简介:虽然已有多种抗逆转录病毒药物被研究作为长效暴露前预防(PrEP)的潜在候选药物,但双月注射用卡替格拉韦——第一种长效 PrEP 形式——已于 2021 年获得批准。在台湾,性事件驱动(ED)PrEP 是男同性恋者、双性恋者和其他与男性发生性关系者(GBMSM)中最常见的给药方案,为观察在每日方案不是主流方法的社区中对长效 PrEP 的偏好提供了独特的环境。本研究旨在确定目前在开发管道中的长效 PrEP 的不同形式和给药间隔的偏好。
方法:我们通过便利抽样于 2021 年对台湾 GBMSM 社交网络应用程序的用户进行了一项调查。我们的调查包括性行为、当前 PrEP 方案以及对长效 PrEP 潜在候选药物的偏好等问题,如植入物、肌肉内和皮下注射。我们比较了潜在长效选择的李克特量表偏好评分,并进行逻辑回归分析,以分别检查与双月肌内注射(2M IM)相对于 ED 和每日 PrEP 方案偏好相关的因素。
结果:共纳入 1728 份符合条件的应答。3%的应答者(n=52)为每日 PrEP 使用者;11.5%(n=198)为 ED PrEP 使用者。不考虑成本时,无论初始给药方案如何,当前 PrEP 使用者最有可能表示对每月口服 PrEP 的偏好,其次是 6 个月皮下注射(6M SC)和 2M IM。然而,在非当前 PrEP 使用者中,每月口服 PrEP 是最受欢迎的形式,其次是 ED、每日口服和 6M SC 注射。多变量逻辑回归显示,当前每日使用者、愿意在未来 6 个月内服用 PrEP 者和过去 12 个月内性伴侣较多者,与对 2M IM 注射剂相对于 ED PrEP 的偏好显著相关。
结论:在台湾的 GBMSM 中,每月口服形式是最受欢迎的长效 PrEP。当前每日 PrEP 使用者更喜欢 2M IM 注射剂而不是 ED PrEP,这使得 2M IM 注射剂成为一种潜在的替代方案。进一步的研究应关注成本和给药方式如何影响 PrEP 偏好及其实际应用。
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