Daily and on-demand HIV pre-exposure prophylaxis with emtricitabine and tenofovir disoproxil (ANRS PREVENIR): a prospective observational cohort study

Molina, Jean‐Michel; Ghosn, Jade; Assoumou, Lambert; Delaugerre, Constance; Algarte-Génin, Michèle; Pialoux, Gilles; Katlama, Christine; Slama, Laurence; Liégeon, Geoffroy; Beniguel, Lydie; Ohayon, Michel; Mouhim, Hanane; Goldwirt, Lauriane; Spire, Bruno; Loze, Bénédicte; Surgers, Laure; Pavie, Juliette; Lourenco, J; Ben-Mechlia, Mohamed; Mestre, Soizic Le; Rojas-Castro, Daniela; Costagliola, Dominique

doi:10.1016/s2352-3018(22)00133-3

Cited by 77 publications

(83 citation statements)

References 21 publications

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“…More recently, the PROUD study found an incidence of 1.2/100py, the DISCOVER study an incidence of 0.34/100py in the TDF/FTC group and the IPERGAY study reported an incidence of 0.91/100py with on-demand TDF/FTC [ 23 – 25 ]. HIV incidence among PrEP users in implementation projects were closer to our findings with 0.16/100py in New South Wales (EPIC-NSW), 0.13/100py in England (PrEP Impact Trial), and 0.11/100py in France (ANRS PREVENIR) [ 26 – 28 ]. Differences in study populations and settings may partly explain differences in HIV incidence.…”

Section: Discussionsupporting

confidence: 81%

See 1 more Smart Citation

Low incidence of HIV infection and decreasing incidence of sexually transmitted infections among PrEP users in 2020 in Germany

Schmidt

Kollan²,

Bartmeyer³

et al. 2022

Infection

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Introduction Objectives of this study, as part of a nation-wide HIV pre-exposure prophylaxis (PrEP) evaluation project, were to determine the incidence of infections with HIV, chlamydia, gonorrhea, syphilis, hepatitis A/B/C in persons using PrEP, and to describe the health care funded PrEP use in Germany. Additionally, factors associated with chlamydia/gonorrhea and syphilis infections were assessed. Methods Anonymous data of PrEP users were collected at 47 HIV-specialty centers from 09/2019–12/2020. Incidence rates were calculated per 100 person years (py). Using longitudinal mixed models, we analyzed risk factors associated with sexually transmitted infections (STIs). Results 4620 PrEP users were included: 99.2% male, median age 38 years (IQR 32–45), 98.6% men who have sex with men (MSM). The median duration of PrEP exposure was 451 days (IQR 357–488), totaling 5132 py. Four HIV infections were diagnosed, incidence rate 0,078/100py (95% CI 0.029–0.208). For two, suboptimal adherence was reported and in the third case, suboptimal adherence and resistance to emtricitabine were observed. One infection was likely acquired before PrEP start. Incidence rates were 21.6/100py for chlamydia, 23.7/100py for gonorrhea, 10.1/100py for syphilis and 55.4/100py for any STI and decreased significantly during the observation period. 65.5% of syphilis, 55.6% of chlamydia and 50.1% of gonorrhea cases were detected by screening of asymptomatic individuals. In a multivariable analysis among MSM younger age, PrEP start before health insurance coverage and daily PrEP were associated with greater risk for chlamydia/gonorrhea. Symptom triggered testing and a history of STI were associated with a higher risk for chlamydia/gonorrhea and syphilis. A significantly lower risk for chlamydia/gonorrhea and syphilis was found for observations during the COVID-19 pandemic period. Conclusions We found that HIV-PrEP is almost exclusively used by MSM in Germany. A very low incidence of HIV infection and decreasing incidence rates of STIs were found in this cohort of PrEP users. The results were influenced by the SARS-CoV-2 pandemic. Rollout of PrEP covered by health insurance should be continued to prevent HIV infections. Increased PrEP availability to people at risk of HIV infection through the elimination of barriers requires further attention. Investigation and monitoring with a longer follow-up would be of value.

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Section: Discussionsupporting

confidence: 81%

“…The cohort of PrEP users studied was largely male, 99% MSM and 83% under the age of 50, which is similar to that in other implementation studies [ 26 – 28 ]. In Germany, PrEP appears to find minimal use outside the MSM community.…”

Section: Discussionsupporting

confidence: 75%

Low incidence of HIV infection and decreasing incidence of sexually transmitted infections among PrEP users in 2020 in Germany

Schmidt

Kollan²,

Bartmeyer³

et al. 2022

Infection

View full text Add to dashboard Cite

show abstract

“…23 , 24 Both daily and on-demand PrEP have been shown to be highly effective in preventing HIV acquisition provided that adherence is good. 25 Promoting both modes of PrEP use and choosing appropriately according to individuals preferences and risk profile could improve adherence to treatment and allow access to this effective HIV prevention tool to a greater number of users. According to the ERAS COVID-19 survey, almost 60% of PrEP users had stopped PrEP and about 6% had switched from continuous to on-demand use during the first wave of COVID-19 pandemic in France.…”

Section: Discussionmentioning

confidence: 99%

Roll-out of HIV pre-exposure prophylaxis use in France: A nationwide observational study from 2016 to 2021

Gage¹,

Desplas²,

Dray‐Spira³

2022

The Lancet Regional Health - Europe

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“…Based on prior work in our group and other cohorts, it has been shown that there is differential participation in condomless acts between main or primary partners and other types of partnerships (casual, anonymous, clients etc), and that there is differential HIV risk associated with CLAI in different partnerships. 21 , 22 , 47 , 48 Therefore, in this study, we used the time-updated count of CLAI acts with all non-main partnership as the exposure of interest. We also explored use of all reported CLAI acts, but found this variable to be less predictive, as expected, and also created distortions in models.…”

Section: Methodsmentioning

confidence: 99%

Dynamic immune markers predict HIV acquisition and augment associations with sociobehavioral factors for HIV exposure

Ignacio¹,

Dasgupta²,

Valdez³

et al. 2022

iScience

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Daily and on-demand HIV pre-exposure prophylaxis with emtricitabine and tenofovir disoproxil (ANRS PREVENIR): a prospective observational cohort study

Cited by 77 publications

References 21 publications

Low incidence of HIV infection and decreasing incidence of sexually transmitted infections among PrEP users in 2020 in Germany

Low incidence of HIV infection and decreasing incidence of sexually transmitted infections among PrEP users in 2020 in Germany

Roll-out of HIV pre-exposure prophylaxis use in France: A nationwide observational study from 2016 to 2021

Dynamic immune markers predict HIV acquisition and augment associations with sociobehavioral factors for HIV exposure

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