Depression and Oral FTC/TDF Pre-exposure Prophylaxis (PrEP) Among Men and Transgender Women Who Have Sex With Men (MSM/TGW)

Abstract

We conducted a longitudinal and cross-sectional analysis of depressive symptomology in iPrEx, a randomized, placebo-controlled trial of daily, oral FTC/TDF HIV pre-exposure prophylaxis (PrEP) in men and transgender women who have sex with men. Depression-related adverse events (AEs) were the most frequently reported severe or life-threatening AEs and were not associated with being randomized to the FTC/TDF arm (152 vs. 144 respectively OR 0.66 95 % CI 0.35–1.25). Center for Epidemiologic Studies Depression scale (CES-D) and a four questions suicidal ideation scale scores did not differ by arm. Participants reporting forced sex at anal sexual debut had higher CES-D scores (coeff: 3.23; 95 % CI 1.24–5.23) and were more likely to have suicidal ideation (OR 2.2; 95 % CI 1.09–4.26). CES-D scores were higher among people reporting non-condom receptive anal intercourse (ncRAI) (OR 1.46; 95 % CI 1.09–1.94). We recommend continuing PrEP during periods of depression in conjunction with provision of mental health services.

Skating on thin ice: stimulant use and sub‐optimal adherence to HIV pre‐exposure prophylaxis

“…Any sexually transmitted infection at enrolment was omitted in the final model as this resulted in a substantially larger standard error. Given the high prevalence of depression among MSM and transgender women and the bivariate association between depression and non‐adherence , we tested for the possible interaction between our predictors of interest and baseline CES‐D score. We also tested for the possible interaction between stimulant use and binge drinking.…”

Pre-exposure prophylaxis for MSM and transgender persons in early adopting countries

“…depression, anxiety, and substance use disorders) are prevalent among persons who may benefit from PrEP and among those who have initiated PrEP [71, 101, 102], so provision of PrEP also offers an opportunity to address these conditions. In a study of the safety and acceptability of PrEP among black MSM in three U.S. cities (HIV Prevention Trials Network Study 073), representing a population with high rates of new HIV infections, 30% of participants reported behavioral health co-morbidities at enrollment [103].…”

High levels of mild to moderate depression among men who have sex with men and transgender women in Lima, Peru: implications for integrated depression and HIV care

“…In this version, scores range from 0-60, again with higher scores indicative of more depressive symptomology; scores of ≥16 have been regarded as clinically significant [46] . In the iPrEx depression analysis, among all (HIV-negative) participants with at least one CES-D score (N=2,131, of whom 1,172 participants were from Peru), the mean CES-D score was 14 (range 0-55), with those in the highest quartile (CES-D ≥20) most likely to report condomless receptive anal intercourse during the previous 3 months [47] . Depression was not associated with PrEP use, though, notably, half of all participants in iPrEx had CES-D scores of ≥16 over the course of the study.…”