Evidence of Nonrandom Mixing by Pre-exposure Prophylaxis Use Among Men Who Have Sex With Men Partnerships in Melbourne, 2016 to 2018

Wang, Linwei; Tan, Darrell H. S.; Mishra, Sharmistha

doi:10.1097/qai.0000000000002387

Cited by 1 publication

(2 citation statements)

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“…18–20 In Australian MSM with low prevalence of PrEP use (3%), concordance of PrEP use was uncommon, 21 but still in excess of the fraction expected by chance alone. 38 We also found evidence of sorting between MSM with diagnosed HIV and those who use PrEP, similar to previous findings, 18,19 and consistent with Centers for Disease Control and Prevention (CDC) guidelines for PrEP indications. 9…”

Section: Discussionsupporting

confidence: 90%

“…[18][19][20] In Australian MSM with low prevalence of PrEP use (3%), concordance of PrEP use was uncommon, 21 but still in excess of the fraction expected by chance alone. 38 We also found evidence of sorting between MSM with diagnosed HIV and those who use PrEP, similar to previous findings, 18,19 and consistent with Centers for Disease Control and Prevention (CDC) guidelines for PrEP indications. 9 Taken together, existing evidence and our new results provide evidence for the concentration of biomedical protection against HIV transmission (i.e., PrEP and U = U) in fewer partnerships throughout the sexual network.…”

Section: Discussionsupporting

confidence: 90%

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Sexual Mixing by HIV Status and Pre-exposure Prophylaxis Use Among Men Who Have Sex With Men: Addressing Information Bias

et al. 2022

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Background: Population-level estimates of sexual network mixing for parameterizing prediction models of pre-exposure prophylaxis (PrEP) effectiveness are needed to inform prevention of HIV transmission among men who have sex with men (MSM). Estimates obtained by egocentric sampling are vulnerable to information bias due to incomplete respondent knowledge. Methods: We estimated patterns of serosorting and PrEP sorting among MSM in the United States using data from a 2017-2019 egocentric sexual network study. Respondents served as proxies to report the HIV status and PrEP use of recent sexual partners. We contrasted results from a complete-case analysis (unknown HIV and PrEP excluded) versus a bias analysis with respondent-reported data stochastically reclassified to simulate unobserved self-reported data from sexual partners. Results: We found strong evidence of preferential partnering across analytical approaches. The bias analysis showed concordance between sexual partners of HIV diagnosis and PrEP use statuses for MSM with diagnosed HIV (39%; 95% simulation interval: 31, 46), MSM who used PrEP (32%; 21, 37), and MSM who did not use PrEP (83%; 79, 87). The fraction of partners with diagnosed HIV was higher among MSM who used PrEP (11%; 9, 14) compared with MSM who did not use PrEP (4%; 3, 5). Comparatively, across all strata of respondents, the complete-case analysis overestimated the fractions of partners with diagnosed HIV or PrEP use. Conclusions: We found evidence consistent with HIV and PrEP sorting among MSM, which may decrease the population-level effectiveness of PrEP. Bias analyses can improve mixing estimates for parameterization of transmission models.

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