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AIDS Care. 2016;28 Suppl 1:48-55. doi: 10.1080/09540121.2016.1146653. Epub 2016 Feb 17.

Uptake of PrEP and condom and sexual risk behavior among MSM during the ANRS IPERGAY trial.

Collaborators (136)

Molina JM, Capitant C, Spire B, Pialoux G, Cotte L, Charreau I, Tremblay C, Le Gall JM, Cua E, Pasquet A, Raffi F, Pintado C, Chidiac C, Chas J, Charbonneau P, Delaugerre C, Suzan-Monti M, Loze B, Fonsart J, Peytavin G, Cheret A, Timsit J, Girard G, Lorente N, Préau M, Rooney JF, Wainberg MA, Thompson D, Rozenbaum W, Doré V, Marchand L, Simon MC, Etien N, Aboulker JP, Meyer L, Delfraissy JF, Pintado C, Loze B, Delaugerre C, Charbonneau P, Gatey C, Ponscarme D, Penot P, Niedbalski L, Veron R, Delgado J, Dalle E, Parlier S, Madelaine I, Fonsart J, Danet M, Mahjoub N, Mezreb N, Moudachirou K, Morel S, Conort G, Lorho F, Meunier M, Rozenbaum W, Molina JM, Chas J, Monfort C, Foucoin J, Boissavy B, Cousseau S, Huon S, Danet M, Djessima A, Berrebi V, Adda A, le Nagat S, Zarka L, Berdougo J, Pialoux G, Chidiac C, Mzoughi N, Clement F, Decouty A, Chapolard C, Godinot M, Adouard-groslafeige C, Koffi J, Pansu A, Becker A, Pailhes S, Bonnet F, Jeanblanc F, Brochier C, Teruin X, Rouby S, Gilly L, Cotte L, Beauvais C, Arlotto P, Fortin C, Talbot A, Chamberland A, McKenzie A, Blanchette M, Rousseau R, Montheuth K, Thompson D, Morin M, Wainberg M, Tremblay C, Etienne C, Tolonin F, Breaud S, Péchenot V, Bagge S, Cepitelli T, Roger PM, Rosenthal E, Cua E, Cheret A, Cornavin P, Vandamme S, Lambec J, Dumon N, Leclanche O, Huleux T, Biekre R, Robineau O, Melliez H, Bazus H, Pasquet A, Bernaud C, Besnier M, Bonnet B, Hall N, Cavellec M, Hue H, Larmet L, Colas M, Choquet R, Raffi F.

Author information

1
a INSERM, UMR912 (SESSTIM) , Marseille , France.
2
b Aix Marseille Université, UMR_S912, IRD , Marseille , France.
3
c ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur , Marseille , France.
4
d Inserm SC10 , Villejuif , France.
5
e Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT), Agència de Salut Pública de Catalunya (ASPC) , Badalona , Spain.
6
f GRePS Lyon 2 Université , Bron , France.
7
g AIDES (Mission Innovation Recherche Expérimentation) , Pantin , France.
8
h Department of Infectious Diseases , Hôpital de la Croix Rousse, INSERM U1052 , Lyon , France.
9
i Department of Infectious Diseases , Hôpital Tenon , Paris , France.
10
j Department of Infectious Disease , Assistance Publique Hôpitaux de Paris, University of Paris Diderot Paris 7, INSERM U941 , Paris , France.

Abstract

The double-blind phase of the randomized ANRS IPERGAY trial, evaluating sexual activity-based oral HIV pre-exposure prophylaxis (PrEP), was conducted among high-risk men who have sex with men (MSM). Results showed an 86% (95% CI: 40-98) relative reduction in HIV incidence among participants with tenofovir disoproxil fumarate-emtricitabine vs. placebo. The present pooled analysis aimed to analyze (i) participants' adherence to the prescribed treatment and/or condom use during sexual intercourse and (ii) sexual behavior during the double-blind phase of the study. Four hundred MSM were enrolled in the trial. Every 2 months they completed online questionnaires collecting sexual behavior and PrEP adherence data regarding their most recent sexual intercourse. A total of 2232 questionnaires (M0-M24) were analyzed. Changes over time were evaluated using a mixed model accounting for multiple measures. Irrespective of sexual partner and practice type, on average, 42.6% (min: 32.1-max: 45.8%) reported PrEP use only during their most recent episode of sexual intercourse; 29% (22.9-35.6%) reported both PrEP and condom use; 11.7% (7.2-18.9%) reported condom-use only, and 16.7% (10.8-29.6%) reported no PrEP or condom use with no significant change during the study. Scheduled (i.e., correct) PrEP use was reported on average by 59.0% (47.2-68.5%) of those reporting PrEP use during their most recent sexual intercourse. Overall, 70.3% (65.3-79.4%) and 69.3% (58.3-75.4%) of participants reported, respectively, condomless anal and condomless receptive anal intercourse during their most recent sexual encounter without significant change during follow-up. Overall, on average 83.3% (min: 70.4-max: 89.2%) of participants protected themselves by PrEP intake or condom use or both during the trial, and no increase in at-risk sexual practices was observed. None of these indicators showed significant trend during the follow-up, although we found a tendency toward decrease (p = .19) of the median number of sexual partners strengthening the absence of behavioral disinhibition. On-demand PrEP within a comprehensive HIV prevention package could improve prevention in MSM.

KEYWORDS:

MSM; On-demand HIV pre-exposure prophylaxis; adherence; sexual behavior

PMID:
26883400
PMCID:
PMC4828609
DOI:
10.1080/09540121.2016.1146653
[Indexed for MEDLINE]
Free PMC Article

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