Pre-exposure Prophylaxis for Human Immunodeficiency Virus

Castel, Amanda D.; Magnus, Manya; Greenberg, Alan E.

doi:10.1016/j.idc.2014.08.001

Cited by 18 publications

(14 citation statements)

References 86 publications

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“…The final set of articles (n = 47) included four broad categories of papers: primary data on cognitive variables (e.g., perspectives, beliefs, and concerns) of HIV-prevention providers (n = 18) [ 9 , 14 , 30 – 45 ]; primary data on cognitive variables and perspectives of individuals considered at risk for HIV infection (n = 9) [ 46 – 54 ]; reviews of current literature on PrEP implementation (n = 16) [ 10 , 11 , 17 , 19 , 55 – 66 ]; and case studies of PrEP demonstration and implementation projects (n = 4) [ 12 , 54 , 67 , 68 ]. From the text of these articles, we extracted and recorded key barriers to implementation and the interventions proposed to address them.…”

Section: Resultsmentioning

confidence: 99%

“…The extant literature consistently suggests that to improve PrEP implementation, key barriers need to be overcome and interventions need to be developed at all levels (clients/patients, HIP service providers, healthcare systems, and policy) [ 17 – 19 ]. Therefore, our review follows a socioecological perspective [ 20 ] suggesting that barriers to PrEP implementation fall within four domains.…”

Section: Methodsmentioning

confidence: 99%

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Improving PrEP Implementation Through Multilevel Interventions: A Synthesis of the Literature

et al. 2018

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There are many challenges to accessing PrEP and thus low uptake in the United States. This review (2007–2017) of PrEP implementation identified barriers to PrEP and interventions to match those barriers. The final set of articles (n = 47) included content on cognitive aspects of HIV service providers and individuals at risk for infection, reviews, and case studies. Cognitive barriers and interventions regarding patients and providers included knowledge, attitudes, and beliefs about PrEP. The “purview paradox” was identified as a key barrier—HIV specialists often do not see HIV-negative patients, while primary care physicians, who often see uninfected patients, are not trained to provide PrEP. Healthcare systems barriers included lack of communication about, funding for, and access to PrEP. The intersection between PrEP-stigma, HIV-stigma, transphobia, homophobia, and disparities across gender, racial, and ethnic groups were identified; but few interventions addressed these barriers. We recommend multilevel interventions targeting barriers at multiple socioecological domains.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Improving PrEP Implementation Through Multilevel Interventions: A Synthesis of the Literature

et al. 2018

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“…Preventing HIV transmission is a major public health challenge [1]. Combined antiretroviral therapy (cART) is a valuable tool in this effort, either as pre-exposure (PrEP) [2] or post-exposure prophylaxis (PEP) [3]. PEP is highly effective in non-human primates in reducing the risk of SIV transmission by 77-95% [4].…”

Section: Introductionmentioning

confidence: 99%

Prescription of Postexposure Prophylaxis for HIV-1 in the Emergency Room: Correct Transmission Risk Assessment Remains Challenging

Marzel

Heinrich

Schilliger

et al. 2017

JAIDS Journal of Acquired Immune Deficiency Syndromes

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“…Researchers are investigating the delivery of PrEP as oral pills that are used intermittently (ie, less than a daily basis), topical gels, vaginal rings, and long-lasting injections [ 21 , 25 , 26 ]. Because high levels of PrEP efficacy are dependent on adherence, there is obvious interest in developing administration modalities that target groups are willing to use.…”

Section: Introductionmentioning

confidence: 99%

Preexposure Prophylaxis Modality Preferences Among Men Who Have Sex With Men and Use Social Media in the United States

Hall¹,

Heneine²,

Sanchez³

et al. 2016

J Med Internet Res

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BackgroundPreexposure prophylaxis (PrEP) is available as a daily pill for preventing infection with the human immunodeficiency virus (HIV). Innovative methods of administering PrEP systemically or topically are being discussed and developed.ObjectiveThe objective of our study was to assess attitudes toward different experimental modalities of PrEP administration.MethodsFrom April to July 2015, we recruited 1106 HIV-negative men who have sex with men through online social media advertisements and surveyed them about their likelihood of using different PrEP modalities. Participants responded to 5-point Likert-scale items indicating how likely they were to use each of the following PrEP modalities: a daily oral pill, on-demand pills, periodic injection, penile gel (either before or after intercourse), rectal gel (before/after), and rectal suppository (before/after). We used Wilcoxon signed rank tests to determine whether the stated likelihood of using any modality differed from daily oral PrEP. Related items were combined to assess differences in likelihood of use based on tissue or time of administration. Participants also ranked their interest in using each modality, and we used the modified Borda count method to determine consensual rankings.ResultsMost participants indicated they would be somewhat likely or very likely to use PrEP as an on-demand pill (685/1105, 61.99%), daily oral pill (528/1036, 50.97%), injection (575/1091, 52.70%), or penile gel (438/755, 58.01% before intercourse; 408/751, 54.33% after). The stated likelihoods of using on-demand pills (median score 4) and of using a penile gel before intercourse (median 4) were both higher than that of using a daily oral pill (median 4, P<.001 and P=.001, respectively). Compared with a daily oral pill, participants reported a significantly lower likelihood of using any of the 4 rectal modalities (Wilcoxon signed rank test, all P<.001). On 10-point Likert scales created by combining application methods, the reported likelihood of using a penile gel (median 7) was higher than that of using a rectal gel (median 6, P<.001), which was higher than the likelihood of using a rectal suppository (median 6, P<.001). The modified Borda count ranked on-demand pills as the most preferred modality. There was no difference in likelihood of use of PrEP (gel or suppository) before or after intercourse.ConclusionsParticipants typically prefer systemic PrEP and are less likely to use a modality that is administered rectally. Although most of these modalities are seen as favorable or neutral, attitudes may change as information about efficacy and application becomes available. Further data on modality preference across risk groups will better inform PrEP development.

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Pre-exposure Prophylaxis for Human Immunodeficiency Virus

Cited by 18 publications

References 86 publications

Improving PrEP Implementation Through Multilevel Interventions: A Synthesis of the Literature

Improving PrEP Implementation Through Multilevel Interventions: A Synthesis of the Literature

Prescription of Postexposure Prophylaxis for HIV-1 in the Emergency Room: Correct Transmission Risk Assessment Remains Challenging

Preexposure Prophylaxis Modality Preferences Among Men Who Have Sex With Men and Use Social Media in the United States

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