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      Between- and Within-Individual Sociodemographic and Psychological Determinants of PrEP Adherence Among Men Who have Sex with Men Prescribed a Daily PrEP Regimen in Wales

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          Abstract

          We investigated the determinants of daily PrEP use and coverage of condomless anal sex (CAS) by PrEP among men who have sex with men in Wales, UK. We measured PrEP use by electronic monitors and CAS by secure online surveys. We defined PrEP use based on daily medication cap openings and coverage as CAS episodes preceded by ≥ 3 days of PrEP use and followed by ≥ 2 days of PrEP use. We included 57 participants (5463 observations). An STI diagnosis was associated with lower PrEP use but also lower PrEP coverage. Older adults had higher PrEP use. A belief that other PrEP users took PrEP as prescribed was associated with lower PrEP coverage. An STI diagnosis is an important cue for an intervention, reflecting episodes of high-risk sexual behaviour and low PrEP coverage. Other results provide a basis for the development of an evidence-informed intervention for promoting coverage of PrEP.

          Supplementary Information

          The online version contains supplementary material available at 10.1007/s10461-022-03890-4.

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          The theory of planned behavior

          Icek Ajzen (1991)
          Organizational Behavior and Human Decision Processes, 50(2), 179-211
          Article 0 comments Cited 7902 times – based on 0 reviews     Review now
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            Preexposure Chemoprophylaxis for HIV Prevention in Men Who Have Sex with Men

            Robert M Grant, Javier R Lama, Peter L Anderson … (2010)
            Antiretroviral chemoprophylaxis before exposure is a promising approach for the prevention of human immunodeficiency virus (HIV) acquisition. We randomly assigned 2499 HIV-seronegative men or transgender women who have sex with men to receive a combination of two oral antiretroviral drugs, emtricitabine and tenofovir disoproxil fumarate (FTC-TDF), or placebo once daily. All subjects received HIV testing, risk-reduction counseling, condoms, and management of sexually transmitted infections. The study subjects were followed for 3324 person-years (median, 1.2 years; maximum, 2.8 years). Of these subjects, 10 were found to have been infected with HIV at enrollment, and 100 became infected during follow-up (36 in the FTC-TDF group and 64 in the placebo group), indicating a 44% reduction in the incidence of HIV (95% confidence interval, 15 to 63; P=0.005). In the FTC-TDF group, the study drug was detected in 22 of 43 of seronegative subjects (51%) and in 3 of 34 HIV-infected subjects (9%) (P<0.001). Nausea was reported more frequently during the first 4 weeks in the FTC-TDF group than in the placebo group (P<0.001). The two groups had similar rates of serious adverse events (P=0.57). Oral FTC-TDF provided protection against the acquisition of HIV infection among the subjects. Detectable blood levels strongly correlated with the prophylactic effect. (Funded by the National Institutes of Health and the Bill and Melinda Gates Foundation; ClinicalTrials.gov number, NCT00458393.).
            Article 0 comments Cited 623 times – based on 0 reviews     Review now
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              Antiretroviral Prophylaxis for HIV Prevention in Heterosexual Men and Women

              Jared Baeten, Deborah Donnell, Patrick Ndase … (2012)
              New England Journal of Medicine, 367(5), 399-410
              Article 0 comments Cited 450 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                David Gillespie:
                ORCID: http://orcid.org/0000-0002-6934-2928
                gillespied1@cardiff.ac.uk
                Journal
                Journal ID (nlm-ta): AIDS Behav
                Journal ID (iso-abbrev): AIDS Behav
                Title: AIDS and Behavior
                Publisher: Springer US (New York )
                ISSN (Print): 1090-7165
                ISSN (Electronic): 1573-3254
                Publication date (Electronic): 2 November 2022
                Publication date PMC-release: 2 November 2022
                Pages: 1-9
                Affiliations
                [1 ]GRID grid.5600.3, ISNI 0000 0001 0807 5670, Centre for Trials Research, College of Biomedical & Life Sciences, School of Medicine, , Cardiff University, ; Cardiff, Wales, UK
                [2 ]GRID grid.10417.33, ISNI 0000 0004 0444 9382, Radboud University Medical Center, Institute of Health Sciences, IQ Healthcare, ; Nijmegen, Netherlands
                [3 ]GRID grid.7362.0, ISNI 0000000118820937, Centre for Health Economics and Medicines Evaluation, , Bangor University, ; Bangor, Wales, UK
                [4 ]GRID grid.7445.2, ISNI 0000 0001 2113 8111, Imperial College London, ; London, England, UK
                [5 ]GRID grid.5600.3, ISNI 0000 0001 0807 5670, Division of Population Medicine and PRIME Centre Wales, College of Biomedical & Life Sciences, School of Medicine, , Cardiff University, ; Cardiff, Wales, UK
                [6 ]GRID grid.439475.8, ISNI 0000 0004 6360 002X, Public Health Wales NHS Trust, ; Cardiff, Wales, UK
                [7 ]GRID grid.439475.8, ISNI 0000 0004 6360 002X, Policy, Research and International Development, , Public Health Wales, ; Cardiff, Wales, UK
                Author information
                http://orcid.org/0000-0002-6934-2928
                Article
                Publisher ID: 3890
                DOI: 10.1007/s10461-022-03890-4
                PMC ID: 9628468
                PubMed ID: 36322216
                SO-VID: 16c4791f-6477-49ba-9446-80d9c02442f8
                Copyright © © The Author(s) 2022
                License:

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                Date accepted : 3 October 2022
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100012068, Health and Care Research Wales;
                Award ID: HF-17-1411
                Award Recipient :
                Categories
                Subject: Original Paper

                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: hiv prevention,prep,adherence,determinants,msm
                Data availability:
                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: hiv prevention, prep, adherence, determinants, msm

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