Advertisement
Advertisement

Spotlight Center on HIV Prevention Today

News

PrEP Updates From the 9th International AIDS Society Conference on HIV Science

August 23, 2017

 < Prev  |  1  |  2 

Dutch Study Explores Motivations for Choosing Daily PrEP versus On-Demand PrEP Among MSM

An ongoing demonstration project called the Amsterdam PrEP Project (AMPrEP) enrolled 376 HIV-negative MSM between June 2015 and February 2017, offering them a choice between taking PrEP daily or on-demand. As part of this study, AMPrEP researchers wanted to investigate the reasons men chose one dosing regimen over the other. Participants were interviewed at baseline about their reasons for choosing daily or on-demand PrEP, and were interviewed again at follow-up visits (every three months) if they decided to switch from one to the other, or decided to stop taking PrEP.

At enrolment, 273 men (73%) chose to take PrEP daily and 103 (27%) started on-demand PrEP. As of February 2017, 44 participants had switched to daily PrEP, and 39 had switched to the on-demand regimen. Participants provided a variety of motives for choosing and switching between regimens, based on expectations (before starting) and actual experiences once on PrEP. Note that participants were able to give more than one reason for their decision.

At baseline, reasons for choosing daily PrEP included the following:

  • Need for daily structure (32%)
  • Anticipated adherence issues with taking PrEP on-demand (31%)
  • Expecting to have unplanned and/or frequent sex (19%)
  • To have or maintain more sexual freedom (4%)
  • Wanting to try out the daily regimen (3%)
  • Fear of side effects related to on-demand PrEP use (1%)
  • Fear of developing drug resistance with on-demand PrEP (<1%)
Advertisement

Reasons given for switching to daily PrEP (after starting on-demand) included the following:

  • Increasing sexual risk behaviour (26%)
  • Having unplanned sex (24%)
  • Desire for more structured adherence (17%)
  • Experiencing side effects from on-demand PrEP (15%)
  • Already taking many pills with on-demand strategy (11%)
  • To gain more sexual freedom (4%)
  • Doubts about the efficacy of on-demand PrEP (4%)

At baseline, reasons for choosing on-demand PrEP included the following:

  • Mostly having planned sex (42%)
  • Only having risky sex occasionally (28%)
  • Concerns about the toxicity and burden of taking medication daily (19%)
  • Anticipated adherence issues with daily PrEP (10%)
  • Wanting to try out the on-demand regimen (<1%)
  • To stop or control sexual risk episodes (<1%)

Reasons given for switching to on-demand PrEP (after starting daily PrEP) included the following:

  • Having less sex than anticipated (30%)
  • Aversion to taking daily medication (25%)
  • Experiencing side effects from daily PrEP (20%)
  • Seeking a better match with current sexual risk behaviour (13%)
  • To stop or control sexual risk episodes (4%)
  • Experiencing adherence problems with daily PrEP (4%)
  • Wanting to experiment with a different regimen (3%)

As of February 2017, 18 participants had stopped PrEP completely. Participants gave the following reasons for stopping PrEP use completely:

  • Experiencing unacceptable side effects (eight participants)
  • Reduced sexual risk (six participants)
  • Changed life circumstances (two participants)
  • Preference for exclusive condom use (one participant)
  • PrEP provoked extreme sexual risk taking (one participant)

This research highlights that people have different preferences for the way they want to take PrEP, and that these preferences can change based on experiences and life circumstances. The study researchers recommend that individuals taking PrEP should be able to choose and switch between PrEP regimens that work best for them, based on their changing personal risk and adherence strategies.


Resources

CATIE statement on the use of oral pre-exposure prophylaxis (PrEP) as a highly effective strategy to prevent the sexual transmission of HIV

Pre-exposure prophylaxis (PrEP) resources

Oral pre-exposure prophylaxis (PrEP) -- fact sheet


References

  1. White E, Dunn D, Gilson R, et al. Long-term follow-up of PROUD: evidence for high continued HIV exposure and durable effectiveness of PrEP. In: Program and abstracts of the 9th International AIDS Society Conference on HIV Science, Paris, July 2017. Abstract TUAC0101. A video of the presentation is available here: https://youtu.be/vvKApONuutE?t=56
  2. Gafos M, Nutland W, Wayal S, et al. Experiences and perceptions of PrEP among gay and other men who have sex with men (MSM) using PrEP in the PROUD study in England. In: Program and abstracts of the 9th International AIDS Society Conference on HIV Science, Paris, July 2017. Abstract TUAC0105. A video of the presentation is available here: https://youtu.be/vvKApONuutE?t=3528
  3. Antoni G, Tremblay C, Charreau, et al. On-demand PrEP with TDF/FTC remains highly effective among MSM with infrequent sexual intercourse: a sub-study of the ANRS IPERGAY trial. In: Program and abstracts of the 9th International AIDS Society Conference on HIV Science, Paris, July 2017. Abstract TUAC0102. A video of the presentation is available here: https://youtu.be/vvKApONuutE?t=918
  4. Landovitz R, Li S, Grinsztein B, et al. Safety, tolerability and pharmacokinetics of long-acting injectable cabotegravir in low-risk HIV-uninfected women and men: HPTN 077. In: Program and abstracts of the 9th International AIDS Society Conference on HIV Science, Paris, July 2017. Abstract TUAC0106LB. A video of the presentation is available here: https://youtu.be/vvKApONuutE?t=4611
  5. Zimmerman H, Eekman S, Achterbergh R, et al. Pre-exposure prophylaxis (PrEP) among men who have sex with mean (MSM) in the Netherlands: motives to choose for, switch to, or stop with daily or event-driven PrEP. In: Program and abstracts of the 9th International AIDS Society Conference on HIV Science, Paris, July 2017. Abstract WEAC0106LB. A video of the presentation is available here: https://youtu.be/snelDMdKIyI?t=3888

[Note from TheBody.com: This article was originally published by PWN-USA on Aug. 23, 2017. We have cross-posted it with their permission.]

 < Prev  |  1  |  2 


Related Stories

This Week in HIV Research: Injectable PrEP Shows Promise in New Study
MK-8591: Further Compelling Early Results for Both Treatment and Prevention
Really Rapid Review -- Paris IAS 2017


This article was provided by Canadian AIDS Treatment Information Exchange. It is a part of the publication The 9th International AIDS Society Conference on HIV Science. Visit CATIE's Web site to find out more about their activities, publications and services.


No comments have been made.
 

Add Your Comment:
(Please note: Your name and comment will be public, and may even show up in
Internet search results. Be careful when providing personal information! Before
adding your comment, please read TheBody.com's Comment Policy.)

Your Name:


Your Location:

(ex: San Francisco, CA)

Your Comment:

Characters remaining:

Advertisement

The content on this page is free of advertiser influence and was produced by our editorial team. See our content and advertising policies.