Pre-exposure prophylaxis for HIV infection and new sexually transmitted infections among men who have sex with men

Kojima, Noah; Davey, Dvora Joseph; Klausner, Jeffrey D.

doi:10.1097/qad.0000000000001185

Cited by 173 publications

(133 citation statements)

References 6 publications

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“…This proves how well connected the MSM sexual networks are and how fast STIs spread through Europe. PreP-receiving MSM engage in high-risk sexual behaviour more frequently than do MSM that do not receive PreP 8. To our knowledge, this is the first case series of HAV infections reported in a PreP clinic, reminding us of the persistent risk of viral and bacterial STIs in people using TDF/FTC PrEP for HIV prevention.…”

Section: Discussionmentioning

confidence: 77%

Hepatitis A infections in men who have sex with men using HIV PrEP in Paris

Penot¹,

Colombier

Maylin

et al. 2018

BMJ Case Reports

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The current hepatitis A outbreak in Europe is largely involving men having sex with multiple male partners. The objective of the present report was to warn teams dealing against the persistent risk of viral and bacterial sexually transmitted infection (STIs) in patients receiving HIV pre-exposure prophylaxis (PrEP). We have notified and investigated three cases of acute hepatitis A virus (HAV) infection in people receiving HIV PrEP in our clinic between December 2016 and March 2017. The patients were not epidemiologically related, had no recent travel history to HAV endemic areas, reported multiple STIs during this period and had not been vaccinated against HAV. They were all identified as genotype A, strain VRD_521_2016 virus.Large-scale vaccination against viral hepatitis is recommended in men having sex with men, especially in those using PrEP, as PrEP is used by people who have high-risk sexual behaviour.

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Section: Discussionmentioning

confidence: 77%

Hepatitis A infections in men who have sex with men using HIV PrEP in Paris

Penot¹,

Colombier

Maylin

et al. 2018

BMJ Case Reports

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“…The social mixing patterns with the use of saunas, and the consumption of recreational drugs that may impair judgment in making decisions about sexual acts are also risk factors for acquisition and transmission of syphilis and other STIs (16,17). Lastly, increased risk-taking behaviours and a rise in STI incidence have been reported among HIV-negative MSM using PrEP (18)(19)(20). In Canada, PrEP was not significantly used in 2010-2015.…”

Section: Discussionmentioning

confidence: 99%

Infectious and congenital syphilis in Canada, 2010–2015

Choudhri

Miller

Sandhu

et al. 2018

Canada Communicable Disease Report

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Background: Syphilis is the third most commonly reported notifiable sexually transmitted infection (STI) in Canada, following chlamydia and gonorrhea, respectively. Rates of this STI have been rising rapidly in Canada since 2001.Objective: To summarize trends observed in syphilis rates for 2010 to 2015 in Canada.Methods: Laboratory-confirmed cases of infectious syphilis and early congenital syphilis were reported to the Public Health Agency of Canada by all of the Canadian provinces and territories. National infectious syphilis rates were computed, as were rates per sex, age group and province/territory. Rates of congenital syphilis were also calculated.Results: From 2010 to 2015, the rate of infectious syphilis in Canada increased by 85.6%, from 5.0 to 9.3 cases per 100,000 population. In 2015, a total of 3,321 cases of infectious syphilis were reported, mainly in males (93.7%), among whom the rate was 17.5 cases per 100,000 males versus 1.2 per 100,000 females. The rate also rose faster among males in 2010-2015, a 90.2% increase versus 27.8% among females. Individuals aged 20-39 years had the highest rates. Across the provinces and territories, the highest rates of infectious syphilis were in Nunavut, British Columbia and Manitoba.

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“…19 Anecdotal epidemiologic observations of declining new HIV infections have buoyed PrEP supporters 20 and the ecological observation of increasing rates of bacterial STIs have galvanized PrEP detractors. 21 The optimal way to support PrEP adherence, and in fact the extent to which such support is required for effectiveness remain areas of great interest and importance to the field. 15 …”

Section: Discussionmentioning

confidence: 99%

Plasma Tenofovir Levels to Support Adherence to TDF/FTC Preexposure Prophylaxis for HIV Prevention in MSM in Los Angeles, California

Landovitz

Beymer

Kofron

et al. 2017

JAIDS Journal of Acquired Immune Deficiency Syndromes

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BACKGROUND TDF/FTC PrEP is effective against rectal HIV acquisition when taken as prescribed. Strategies that identify and intervene with those challenged by adherence to daily medication are needed. SETTING PATH-PrEP was an open-label single arm interventional cohort study conducted at 2 community-based clinical sites in Los Angeles, California. METHODS We enrolled self-identified MSM and TGW ≥18 years of age at elevated risk of HIV acquisition. Participants received a PEP or PrEP-based HIV prevention package for at least 48 weeks. Plasma TFV levels from each PrEP visit assessed as below the limit of quantiatation (<10 ng/mL) triggered increased adherence support. RESULTS 301 participants enrolled. Forty-eight-week retention in the PrEP cohort was 75.1%. Biomarker evidence of PrEP adherence consistent with ≥4 doses per week at weeks 4, 12, 24, 36, and 48 were found in 83.1%, 83.4%, 75.7%, 71.6%, and 65.5% of participants; younger and African-American participants were less likely to have protective drug levels. Most of those with suboptimal adherence had adherence improvement after brief intervention. One seroconversion occurred in a participant who discontinued PrEP. Nearly half (46.4%) of participants were diagnosed with at least one incident STI during 48 weeks of study follow-up. CONCLUSIONS AND RELEVANCE PrEP was acceptable and well tolerated in a diverse population of MSM in Los Angeles. A brief intervention triggered from biomarkers of poor adherence was associated with improved adherence. Drug level monitoring has the potential to allow targeting of additional adherence support to those struggling with daily tablet adherence.

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Pre-exposure prophylaxis for HIV infection and new sexually transmitted infections among men who have sex with men

Cited by 173 publications

References 6 publications

Hepatitis A infections in men who have sex with men using HIV PrEP in Paris

Hepatitis A infections in men who have sex with men using HIV PrEP in Paris

Infectious and congenital syphilis in Canada, 2010–2015

Plasma Tenofovir Levels to Support Adherence to TDF/FTC Preexposure Prophylaxis for HIV Prevention in MSM in Los Angeles, California

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