O19.2 Pre-exposure prophylaxis and risk compensation: evidence of decreased condom use at three-month follow-up among predominantly gay male participants in the vicprep study

Abstract

ment (RIVM), AIDS Fonds, The Netherlands, and UNESCO Bangkok. He has received lecture sponsorship from BMS Australia, is a board member of ACON Health Inc and a member of the Steering Committee of the HIV in Europe initiative. Dean Murphy receives funding from the Australian Government Department of Health and a research grant from the Victorian Department of Health. Luxi Lal has no interests to disclose. Jennifer Audsley has no interests to disclose. Norman Roth has received honoraria for Advisory Boards and/or educational events from ViiV, MSD, Gilead and Bristol Myers Squibb. Richard Moore has received financial assistance for education from Gilead, Viiv and Merck. BK Tee has no interests to disclose. Tim Read works at Melbourne Sexual Health Centre which receives study payments from Gilead.

The effect of HIV prevention products on incentives to supply condomless commercial sex among female sex workers in South Africa

“…Some data from oral PrEP trials, largely among MSM populations, indicate that self-reported condom use has not changed among PrEP users (Carlo Hojilla et al, 2016;Liu et al, 2013;Molina et al, 2015;Thomas et al, 2016). In contrast, a number of MSM studies have detected increased STI rates among PrEP users than nonusers, an objective indication of increased levels of condomless sex (de Wit et al, 2015;Lal et al, n.d.;Marcus et al, 2016;Montano et al, 2017). Mathematical modeling work suggests that, if present, condom substitution may substantively reduce the impact of partially effective products (Foss, Vickerman, Heise, & Watts, 2003;Punyacharoensin et al, 2016).…”

Risk Perception, Sexual Behaviors, and PrEP Adherence Among Substance-Using Men Who Have Sex with Men: a Qualitative Study

“…While risk compensation was not observed in three large PrEP randomized controlled trials (Liu et al, 2013; Marcus et al, 2013; Mugwanya et al, 2013), these studies provided extensive prevention education, including promotion of continued condom use and intensive risk-reduction counseling. Data from the few emergent studies of routine clinical practice suggest variable responses upon initiating PrEP, with a significant subset of PrEP users reporting decreased condom use (de Wit et al, 2015; Gibson et al, 2016; Parker et al, 2015; Volk et al, 2015), reflecting observed differences between trials and real-world PrEP implementation. Differences in evidence of risk compensation reported from PrEP clinical trials, demonstration projects, and routine clinical practice suggest that sexual decision-making and risk-taking behavior may be more complex in real-world situations where substance use, relational, and other situational factors may exert more influence and repeated, intensive prevention messaging including condom promotion may be lacking.…”

Targeting Human Immunodeficiency Virus Pre-Exposure Prophylaxis to Adolescent Sexual Minority Males in Higher Prevalence Areas of the United States: A Modeling Study

“…While preliminary ATN 113 results do not mention risk compensation directly, STI incidence declined over the study, suggesting little evidence of risk compensation (15). However, recent reports find risk compensation in adults (35–37), and any PrEP roll-out among adolescents would need to monitor closely for similar evidence.…”