Risk Compensation in Response to HIV Prevention

Eaton, Lisa A.; Westercamp, Nelli; Abraham, Aushin

doi:10.1007/978-1-4614-8845-3_6

Cited by 3 publications

(3 citation statements)

References 96 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Concerns have been raised that risk compensation (decreased perceptions of HIV risk and less condom use) might undermine the effectiveness of PrEP. [5][6][7] In recent systematic reviews of randomised trials, 1,8 no evidence was found of increased condomless sex by PrEP users, but participants in these studies were unaware whether they were receiving PrEP or a placebo. In open-label and cohort studies of PrEP users, [9][10][11][12] condomless sex had become more frequent over time, but this does not seem to diminish the efficacy of PrEP if drug adherence is maintained.…”

Section: Introductionmentioning

confidence: 99%

Community-level changes in condom use and uptake of HIV pre-exposure prophylaxis by gay and bisexual men in Melbourne and Sydney, Australia: results of repeated behavioural surveillance in 2013–17

et al. 2018

View full text Add to dashboard Cite

Section: Introductionmentioning

confidence: 99%

Community-level changes in condom use and uptake of HIV pre-exposure prophylaxis by gay and bisexual men in Melbourne and Sydney, Australia: results of repeated behavioural surveillance in 2013–17

et al. 2018

View full text Add to dashboard Cite

“…Understanding the important barriers and facilitators of PrEP use is essential for designing effective PrEP programs. 1,2 …”

Section: Introductionmentioning

confidence: 99%

The Role of Social Relationships in PrEP Uptake and Use Among Transgender Women and Men Who Have Sex with Men

et al. 2018

View full text Add to dashboard Cite

Qualitative studies suggest that social relationships play an important role in HIV pre-exposure prophylaxis (PrEP) use, but there have been few quantitative assessments of the role of social relationships in PrEP uptake or adherence. We examined the association between disclosure of study participation or LGBT identity and PrEP use in the 1603 HIV-negative participants enrolled in the iPrEx OLE study. We also evaluated the association between LGBT social group involvement and PrEP use. Study participation disclosure to parents and LGBT identity disclosure to anyone in a participant's social network were associated with greater PrEP uptake. Study participation disclosure to partners was associated with higher probability of having protective PrEP drug concentrations compared [risk difference 0.15 95% CI (0.01, 0.30)]. For each additional type of LGBT organization a participant was involved in, the probability of PrEP uptake and having protective drug concentrations increased by 0.04 [95% CI (0.03, 0.06)] and 0.04 (95% CI (0.02, 0.07)] respectively. Overall, social context was associated with PrEP use in iPrEx OLE, and should be taken into consideration when designing future PrEP implementation programs.

show abstract

“…A tension that remains in the discussion of the appropriateness of microbicides for women relates to the partial efficacy of microbicides found to date and the fear of risk compensation reducing the role of condoms in HIV prevention [14]. To date, all studies that have been able to measure efficacy have shown only partial efficacy [15], and so for optimal effectiveness, and to prevent other STIs, microbicides should be used in tandem with condoms, if possible.…”

Section: Introductionmentioning

confidence: 99%

Women and ARV‐based HIV prevention – challenges and opportunities

Geary

Bukusi

2014

Journal of the International AIDS Society

View full text Add to dashboard Cite

ARV-based HIV prevention methods available in pill, gel or ring formulations (broadly referred to as microbicides) offer the possibility of protection against HIV for women who find it difficult because they cannot ask their partners to use condoms or even refuse sex. Partial efficacy of ARV-based medications has been demonstrated in a number of clinical trials around the world among various populations, building the evidence that ARV-based technologies will contribute to reducing the AIDS epidemic worldwide. Disappointing results, however, from two trials in sub-Saharan Africa, where poor adherence contributed to study closure due to futility, have raised questions about whether women at the centre of the epidemic are able to effectively use products that require routine use. Also, there are fears by some of risk compensation by decreased condom use because of the availability of microbicides when only partial efficacy has been demonstrated in microbicide trials to date. Of note, sub-analyses of biologic measures of adherence in trials where this was possible have shown a strong correlation between good adherence and efficacy, reinforcing the necessity of good adherence. Research conducted in conjunction with clinical trials and post-trials in advance of possible rollout of ARV-based products have examined social and cultural factors, gender-related and otherwise, influencing adherence and other aspects of women's use of products. These include HIV stigma, women's perception of risk, partner and community influences and the differing needs of women in various stages of life and in different circumstances. It is the purpose of this supplement to give voice to the needs of women who can benefit from woman-initiated methods by presenting research results and commentary to contribute to the global conversation about optimizing women's experience with ARV-based prevention.

show abstract

Risk Compensation in Response to HIV Prevention

Cited by 3 publications

References 96 publications

Community-level changes in condom use and uptake of HIV pre-exposure prophylaxis by gay and bisexual men in Melbourne and Sydney, Australia: results of repeated behavioural surveillance in 2013–17

Community-level changes in condom use and uptake of HIV pre-exposure prophylaxis by gay and bisexual men in Melbourne and Sydney, Australia: results of repeated behavioural surveillance in 2013–17

The Role of Social Relationships in PrEP Uptake and Use Among Transgender Women and Men Who Have Sex with Men

Women and ARV‐based HIV prevention – challenges and opportunities

Contact Info

Product

Resources

About