Effect of Truvada lawsuit advertising on preexposure prophylaxis attitudes and decisions among sexual and gender minority youth and young adults at risk for HIV

Abstract

Objective: In 2019, US advocates reported misleading language regarding the safety of TDF/FTC (Truvada) used by lawsuit advertisements against Gilead Sciences. We sought to ascertain the reach and effects of the advertisements on preexposure prophylaxis (PrEP) opinions and decisions in a cohort of youth and young adults at-risk for HIV. Design: An online survey was administered to participants enrolled in Keeping it LITE, a prospective US cohort study of ethnically diverse, sexually active, cisgender and transgender persons ages 13–37. Methods: Quantitative data were analyzed using descriptive and inferential analysis in SAS, and qualitative data via thematic analysis. Results: Survey response rate was 51.3% (n = 1485). Mean age at baseline was 24. Previous PrEP use was reported by 43% of respondents and 32.7% reported PrEP use in the past 6 months. Almost half (48.7%) were aware of the lawsuit. Most of these participants (81.3%) reported the advertisements did not impact their PrEP use, but 13.2% decided to not to begin a Truvada-based PrEP regimen and 5.5% decided to stop taking Truvada due to the advertisements claims. Predictors of changing PrEP behavior were lower education and no previous PrEP use. The qualitative analysis revealed the advertisements increased skepticism about safety and benefit of Truvada PrEP and led to greater distrust of the pharmaceutical industry. Conclusion: The advertisements reached a large, diverse US audience. Disturbingly, 18.7% of PrEP candidates who were aware of the lawsuit attributed not initiating or cessation of a Truvada-based PrEP regimen to exposure to the Truvada lawsuit advertisements.

Digital Epidemiologic Research on Multilevel Risks for HIV Acquisition and Other Health Outcomes Among Transgender Women in Eastern and Southern United States: Protocol for an Online Cohort

“…Technology is increasingly integrated into HIV research through sampling and recruitment methods via online advertisements on social media and dating apps as well as electronic peer referral methods [26,27]; electronic and remote data collection [28][29][30]; and remote specimen collection for biologic measures [31][32][33]. These tools have permitted enrollment of large samples of participants for behavioral surveys [34][35][36], cohort research [37][38][39], and intervention research [40,41]. The development of SMS and smartphone apps has become an increasingly common method to deliver prevention and care interventions [42][43][44][45], while gaming methods have been incorporated to maintain participant engagement, particularly among youth, in research activities and to promote health behaviors [45,46].…”

Limited Interaction Targeted Epidemiology of HIV in Sexual and Gender Minority American Adolescents and Adults: Feasibility of the Keeping it LITE Study

“…Response rates to adjunct survey measures were mixed, with some successful surveys leading to independent publications [ 12 , 13 ]. Over half of the participants in the cohort responded to the COVID-19 survey (2182/3444, 67.26%) [ 13 ].…”

“…This included a brief survey in late November 2019-December 2019 to evaluate the effects of misleading advertisements seeking plaintiffs in a lawsuit against Gilead for Truvada toxicities [ 12 ]; a survey in May and September of 2020 and May of 2021 to ascertain how the COVID-19 pandemic was affecting the mental, financial, and sexual health of participants [ 13 ]; and a short survey in October of 2020 to better understand youth aged 13-17 years who screened eligible but chose not to enroll. The results of the first two surveys are beyond the scope of this study and have been presented and discussed elsewhere [ 12 , 13 ]. The methods of the latter survey are discussed here to provide insight into the recruitment and retention of minor participants.…”

Calcium Channels in Adult Brain Neural Stem Cells and in Glioblastoma Stem Cells

“…CaBP also play essential roles in modulation of NSC activity. Among these, NFAT, especially the NFATc1 and NFATc3 isoforms, is expressed in newborn rodent V-SVZ cell cultures (Serrano-Pérez et al, 2015). Interestingly, the recruitment of NFAT occurred only in response to local Ca 2+ signals obtained following SOC activation but not global Ca 2+ transients, illustrating that specific Ca 2+ patterns are required for selective responses (Somasundaram et al, 2014).…”

“…Interestingly, the recruitment of NFAT occurred only in response to local Ca 2+ signals obtained following SOC activation but not global Ca 2+ transients, illustrating that specific Ca 2+ patterns are required for selective responses (Somasundaram et al, 2014). Analysis of NFAT function showed that the NFAT inhibitor VIVIT slowed cell cycle in NSCs and reduced their ability to differentiate (Serrano-Pérez et al, 2015). Yet, a possible involvement of NFAT for keeping a multipotential stem cell state, that has been observed in embryonic stem cells (MacDougall et al, 2019), remains to be investigated.…”