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AIDS Care. 2019 Oct;31(10):1228-1233. doi: 10.1080/09540121.2019.1595523. Epub 2019 Mar 20.

Effective use of pre-exposure prophylaxis (PrEP) Among stimulant users with multiple condomless sex partners: a longitudinal study of men who have sex with men in Los Angeles.

Author information

1
a Division of Infectious Diseases, David Geffen School of Medicine at UCLA , Los Angeles , CA , USA.
2
b Health and Mental Health Services, Los Angeles LGBT Center , Los Angeles , CA , USA.
3
c UCLA Center for Clinical AIDS Research & Education (CARE) , Los Angeles , CA , USA.
4
d Department of Health Behavior and Health Education, University of Michigan School of Public Health , Ann Arbor , MI , USA.
5
e Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital , Boston , MA , USA.
6
f Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado , Aurora , CO , USA.
7
g OASIS Clinic, Charles R. Drew University of Medicine and Science , Los Angeles , CA , USA.
8
h Gilead Sciences , Foster City , CA , USA.
9
i Division of HIV and STD Programs, Los Angeles County Department of Public Health , Los Angeles , CA , USA.

Abstract

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.

KEYWORDS:

MSM; PrEP; adherence; condomless anal sex; stimulant

PMID:
30894013
PMCID:
PMC6663637
[Available on 2020-10-01]
DOI:
10.1080/09540121.2019.1595523

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