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男男性行为者口腔暴露前预防依从性的实时数字干预:随机对照试验

Real-time digital intervention on oral pre-exposure prophylaxis adherence among MSM: randomized controlled trial.

作者信息

Chu Zhen-Xing, Jin Xia, Ye Ze-Hao, Zhu Yan-Yan, Huang Xiao-Jie, Wang Hui, Chen Yao-Kai, An Yu-Jing, Wu Zhen-Hao, Jiang Yong-Jun, Hu Qing-Hai, Shang Hong

机构信息

State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, NHC Key Laboratory of AIDS Prevention and Treatment, National Clinical Research Centre for Laboratory Medicine, The First Hospital of China Medical University, China Medical University, Shenyang, 110001, China.

Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, 110001, China.

出版信息

NPJ Digit Med. 2025 Jun 11;8(1):349. doi: 10.1038/s41746-025-01743-7.


DOI:10.1038/s41746-025-01743-7
PMID:40500334
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12159155/
Abstract

Oral pre-exposure prophylaxis (PrEP) effectively prevents HIV among men who have sex with men, but its adherence faces significant hindrances. We evaluated the effectiveness of real-time digital intervention in promoting oral PrEP adherence through a randomized controlled trial using electronic medication monitors. The trial was registered on the Chinese Clinical Trial Registry (ChiCTR1900025604) and randomized 442 MSM to intervention (247) or control group (195). At the 6-month follow-up, the intervention group exhibited significantly higher oral PrEP adherence than the control (83.1% vs. 59.8%; adjusted net difference: 21.0%, 95% confidence interval: 12.9-29.2%, p < 0.001), while no differences were detected in the number of male sexual partners, condomless anal intercourse prevalence, or substance use disorder, with consistent results across both daily and event-driven oral PrEP regimens. Therefore, digital intervention significantly increased oral PrEP adherence over 6 months in the daily and event-driven subgroups but demonstrated no effect on high-risk behaviors.

摘要

口服暴露前预防(PrEP)能有效预防男男性行为者感染艾滋病毒,但其依从性面临重大障碍。我们通过一项使用电子药物监测器的随机对照试验,评估了实时数字干预在促进口服PrEP依从性方面的有效性。该试验已在中国临床试验注册中心注册(注册号:ChiCTR1900025604),将442名男男性行为者随机分为干预组(247人)和对照组(195人)。在6个月的随访中,干预组的口服PrEP依从性显著高于对照组(83.1%对59.8%;调整后的净差异:21.0%,95%置信区间:12.9 - 29.2%,p < 0.001),而在男性性伴侣数量、无保护肛交流行率或物质使用障碍方面未发现差异,每日和事件驱动的口服PrEP方案的结果一致。因此,数字干预在每日和事件驱动亚组中显著提高了6个月内的口服PrEP依从性,但对高危行为没有影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30fa/12159155/845725c0f559/41746_2025_1743_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30fa/12159155/8ca07dfd3920/41746_2025_1743_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30fa/12159155/b1794a3f61c2/41746_2025_1743_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30fa/12159155/845725c0f559/41746_2025_1743_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30fa/12159155/8ca07dfd3920/41746_2025_1743_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30fa/12159155/b1794a3f61c2/41746_2025_1743_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/30fa/12159155/845725c0f559/41746_2025_1743_Fig3_HTML.jpg

相似文献

[1]
Real-time digital intervention on oral pre-exposure prophylaxis adherence among MSM: randomized controlled trial.

NPJ Digit Med. 2025-6-11

[2]
Risk-Taking Behaviors and Adherence to HIV Pre-Exposure Prophylaxis in Users of Geosocial Networking Apps: Real-World, Multicenter Study.

J Med Internet Res. 2020-10-14

[3]
Daily and event-driven pre-exposure prophylaxis for men who have sex with men in Belgium: results of a prospective cohort measuring adherence, sexual behaviour and STI incidence.

J Int AIDS Soc. 2019-10

[4]
Comparison between daily and on-demand PrEP (pre-exposure prophylaxis) regimen in covering condomless anal intercourse for men who have sex with men in Hong Kong: A randomized, controlled, open-label, crossover trial.

J Int AIDS Soc. 2021-9

[5]
Study on Pre-Exposure Prophylaxis Regimens among Men Who Have Sex with Men: A Prospective Cohort Study.

Int J Environ Res Public Health. 2019-12-9

[6]
Sexual behaviour and incidence of sexually transmitted infections among men who have sex with men (MSM) using daily and event-driven pre-exposure prophylaxis (PrEP): Four-year follow-up of the Amsterdam PrEP (AMPrEP) demonstration project cohort.

PLoS Med. 2024-5

[7]
Medication Non-adherence and Condomless Anal Intercourse Increased Substantially During the COVID-19 Pandemic Among MSM PrEP Users: A Retrospective Cohort Study in Four Chinese Metropolises.

Front Med (Lausanne). 2022-4-29

[8]
Pre-exposure prophylaxis in real life: experience from a prospective, observational and demonstration project among men who have sex with men in Benin, West Africa.

J Int AIDS Soc. 2023-6

[9]
Real-time monitoring and just-in-time intervention for adherence to pre-exposure prophylaxis among men who have sex with men in China: a multicentre RCT study protocol.

BMC Public Health. 2020-7-24

[10]
Imperfect adherence in real life: a prevention-effective perspective on adherence to daily and event-driven HIV pre-exposure prophylaxis among men who have sex with men - a prospective cohort study in Taiwan.

J Int AIDS Soc. 2021-5

本文引用的文献

[1]
Associations Between PrEP Stigma, PrEP Confidence, and PrEP Adherence: Conditional Indirect Effects of Anticipated HIV Stigma.

J Acquir Immune Defic Syndr. 2024-10-1

[2]
Twice-Yearly Lenacapavir or Daily F/TAF for HIV Prevention in Cisgender Women.

N Engl J Med. 2024-10-3

[3]
Sexual behaviour and incidence of sexually transmitted infections among men who have sex with men (MSM) using daily and event-driven pre-exposure prophylaxis (PrEP): Four-year follow-up of the Amsterdam PrEP (AMPrEP) demonstration project cohort.

PLoS Med. 2024-5

[4]
Mpox Diagnosis, Behavioral Risk Modification, and Vaccination Uptake among Gay, Bisexual, and Other Men Who Have Sex with Men, United Kingdom, 2022.

Emerg Infect Dis. 2024-5

[5]
Optimal strategies to improve uptake of and adherence to HIV prevention among young people at risk for HIV acquisition in the USA (ATN 149): a randomised, controlled, factorial trial.

Lancet Digit Health. 2024-3

[6]
Preexposure Prophylaxis for the Prevention of HIV: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force.

JAMA. 2023-8-22

[7]
The future of HIV pre-exposure prophylaxis adherence: reducing barriers and increasing opportunities.

Lancet HIV. 2023-6

[8]
Human Immunodeficiency Virus Seroconversion Among Men Who Have Sex With Men Who Use Event-Driven or Daily Oral Pre-Exposure Prophylaxis (CohMSM-PrEP): A Multi-Country Demonstration Study From West Africa.

Clin Infect Dis. 2023-8-22

[9]
PrEPare for Work: A Pilot Randomized Controlled Trial of an Intervention to Optimize HIV PrEP Outcomes Among Male Sex Workers.

AIDS Behav. 2023-10

[10]
Effectiveness, reach, uptake, and feasibility of digital health interventions for adults with hypertension: a systematic review and meta-analysis of randomised controlled trials.

Lancet Digit Health. 2023-3

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