Long-term protection from HIV infection with oral HIV pre-exposure prophylaxis in gay and bisexual men: findings from the expanded and extended EPIC-NSW prospective implementation study

Grulich, Andrew E.; Jin, Fengyi; Bavinton, Benjamin R.; Yeung, Barbara; Hammoud, Mohamed; Amin, Janaki; Cabrera, Gesalit; Clackett, Shawn; Ogilvie, Erin; Vaccher, Stefanie; Vickers, Tobias; McNulty, Anna; Smith, David J.; Dharan, Nila; Selvey, Christine; Power, Cherie; Price, Karen; Zablotska, Iryna; Baker, David; Bloch, Mark; Brown, Katherine; Carmody, Christopher; Carr, Andrew; Chanisheff, Daniel; Doong, Nicholas; Finlayson, Robert; Lewis, David A.; Lusk, Josephine; Martin, Sarah; Ooi, Catriona; Read, Phillip; Ryder, Nathan; Smith, Don; Soo, Clara Tuck Meng; Templeton, David J; Vlahakis, Emmanuel; Guy, Rebecca

doi:10.1016/s2352-3018(21)00074-6

Cited by 61 publications

(71 citation statements)

References 22 publications

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“…The results and methodology of EPIC-NSW have been published previously. 2,22,23 Eligibility for EPIC-NSW included being aged 18 years or older, residing in NSW or visiting regularly, being HIV negative, and at high and ongoing risk of HIV infection as defined by the NSW PrEP guidelines. 23 Participants of EPIC-NSW were provided PrEP and instructed to take it daily.…”

Section: Participants and Recruitmentmentioning

confidence: 99%

Incorrect Knowledge of Event-Driven PrEP “2-1-1” Dosing Regimen Among PrEP-Experienced Gay and Bisexual Men in Australia

Chan

Vaccher

Fraser

et al. 2022

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background:Event-driven pre-exposure prophylaxis (ED-PrEP), when taken according to the “2-1-1” dosing method, is highly effective at preventing HIV acquisition for gay, bisexual, and other men who have sex with men (GBM). Any missed doses when using ED-PrEP drastically reduce its effectiveness, so it is vital that people using this method know how to take it correctly. This study investigated Australian GBM's awareness of ED-PrEP and their knowledge of how to take it correctly.Method:We conducted a survey of 1471 PrEP-experienced GBM in Australia, between October 2019 and March 2020. The survey assessed awareness and knowledge of the 3 components of the “2-1-1” ED-PrEP dosing regimen (number of pills for loading dose, timing of loading dose, and number of days after sex to take PrEP pills) among GBM. Characteristics associated with ED-PrEP awareness and correct knowledge of how to take ED-PrEP were assessed with multivariate logistic regression.Results:Two-thirds (n = 1004, 68.4%) had heard of ED-PrEP, of whom only one-eighth (n = 125, 12.5%) knew the correct details of the “2-1-1” ED-PrEP method; one-third (n = 339, 33.8%) did not know any of the 3 key components. Awareness of ED-PrEP and correct knowledge was associated with greater belief in PrEP efficacy, university education, and intention to take a nondaily PrEP regimen in the next 6 months.Conclusions:Although ED-PrEP awareness was considerable, most participants did not know how to use ED-PrEP correctly. Further work is needed to increase awareness and knowledge of ED-PrEP among GBM.

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Section: Participants and Recruitmentmentioning

confidence: 99%

Incorrect Knowledge of Event-Driven PrEP “2-1-1” Dosing Regimen Among PrEP-Experienced Gay and Bisexual Men in Australia

Chan

Vaccher

Fraser

et al. 2022

JAIDS Journal of Acquired Immune Deficiency Syndromes

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“…Preexposure prophylaxis of HIV based on oral tenofovir disoproxil/emtricitabine (FTC) is highly effective in preventing HIV infection in men and women [1]. PrEP roll-out, as part of a combination prevention approach, has the potential to reduce the number of new HIV infections at the population level [2]. However, to significantly curtail the HIV epidemic, scale-up is urgently needed and, considering resources available, would require some demedicalization processes.…”

Section: Introductionmentioning

confidence: 99%

Safety of oral tenofovir disoproxil - emtricitabine for HIV preexposure prophylaxis in adults

Liégeon¹

2022

Current Opinion in HIV and AIDS

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Purpose of reviewThis review focuses on the safety of oral tenofovir disoproxil and emtricitabine (FTC) combination for HIV preexposure prophylaxis (PrEP) in adults. Recent findingsGastrointestinal adverse events are common after treatment initiation but usually resolve within weeks. Although clinical trials did not report an increased risk of serious renal adverse events or tubulopathy, metaanalyses suggest that tenofovir disoproxil -FTC is associated with a slight but non-clinically relevant decline in estimated glomerular filtration rate (eGFR). A decline to less than 60 mL/min remains a rare event, which mainly occurs in users with an age >50 years or a baseline creatinine clearance < 90 mL/min. Similarly, a slight reduction in bone mineral density (BMD) was observed in clinical trials, but it did not result in an increased risk of bone fracture. BMD reduction and eGFR decline tend to resolve after treatment discontinuation. No drug interaction with contraception has been reported in women and no safety signal emerged in pregnant and breastfeeding women. SummaryOral tenofovir disoproxil-FTC for HIV PrEP appears safe and well tolerated for most individuals. This supports demedicalization strategies aiming at increasing the number of PrEP users.

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“…Most men in this sample were gay-identified and strongly embedded in gay community life, both where they live and through their friendship networks. Past experience with HIV and with biomedical forms of HIV prevention [ 13 , 17 ] may have facilitated greater confidence with health systems in general and with medical interventions to prevent disease specifically. This may explain the expressed willingness of most men to assist with COVID-19 contact tracing if required, particularly those who had been vaccinated, similar to what occurred during an outbreak among GBM in the United States [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…Also, experiences of stigma may reduce the willingness of GBM to cooperate with contact tracing efforts [ 12 ]. Alternatively, biomedical prevention interventions, including HIV pre-exposure prophylaxis (PrEP), have resulted in substantial reductions in HIV infections among GBM [ 17 ]. So, GBM may be similarly open to biomedical interventions to prevent COVID-19, including vaccines.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 Vaccine Uptake and Its Impacts in a Cohort of Gay and Bisexual Men in Australia

et al. 2022

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Successful use of biomedical forms of HIV risk-reduction may have predisposed many gay and bisexual men (GBM) to vaccination against COVID-19, which may, in turn, affect their sexual behavior. A total of 622 Australian GBM provided weekly data on COVID-19 vaccination history and sexual behaviour between 17 January 2021 and 22 June 2021. We identify factors associated with COVID-19 vaccination, and compare sexual behavior before and since vaccination. Mean age was 47.3 years (SD 14.0). At least one-dose vaccination coverage had reached 57.2%, and 61.3% reported that the majority of their friends intended to be vaccinated. Vaccinated men reported a mean of 1.11 (SD 2.10) weekly non-relationship sex partners before vaccination and 1.62 (SD 3.42) partners following vaccination. GBM demonstrated high confidence in COVID-19 vaccines. Their sexual activity increased following vaccination suggesting that greater sexual freedom may be a specific motivation for vaccine uptake among some men.

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Long-term protection from HIV infection with oral HIV pre-exposure prophylaxis in gay and bisexual men: findings from the expanded and extended EPIC-NSW prospective implementation study

Cited by 61 publications

References 22 publications

Incorrect Knowledge of Event-Driven PrEP “2-1-1” Dosing Regimen Among PrEP-Experienced Gay and Bisexual Men in Australia

Incorrect Knowledge of Event-Driven PrEP “2-1-1” Dosing Regimen Among PrEP-Experienced Gay and Bisexual Men in Australia

Safety of oral tenofovir disoproxil - emtricitabine for HIV preexposure prophylaxis in adults

COVID-19 Vaccine Uptake and Its Impacts in a Cohort of Gay and Bisexual Men in Australia

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