July 25, 2019 | ALEXANDRA WARD
One strategy to increase the use of pre-exposure prophylaxis (PrEP) in areas where its implementation is limited is to promote same-day initiation. In Latin America, where the HIV epidemic persists, especially among men who have sex with men (MSM) and transgender women (TGW), healthcare resources are often scarce, and new tactics are needed to increase PrEP use.
The ImPrEP study evaluated the feasibility and safety of same-day initiation of oral tenofovir plus emtricitabine (TDF/FTC) among high-risk men who have sex with men (MSM) and transgender women (TGW) in Brazil, Peru, and Mexico. The results were presented at the 10th IAS Conference on HIV Science (IAS 2019).
Between February 2018 and April 2019, researchers recruited, assessed, and enrolled 4954 HIV-negative men who have sex with men (MSM) and women with multiple sexual partners (WSMBs) aged ≥18 years who met the 1+ risk criterion (Brazil [3205], Peru [1010], and Mexico [739]). The median age of participants was 29 years (interquartile range [IQR] 24–36), and MSM comprised 94% (4648/4954) of the study population. WSMBs constituted the remaining 6% (306/4954) of participants.
Participants underwent creatinine, hepatitis B, and sexually transmitted infections testing, and were administered on the same day, as well as a 30-day supply of TDF/FTC.
The primary outcomes were early continuation of PrEP defined as attendance at the first 2 follow-up visits within 120 days of initiation, plus adherence by using pharmacy refill data defined as 16 days of PrEP medicines dispensed per 30-day period (medicine possession ratio ≥0.53).
In total, ImPrEP accumulated 1329.6 person-years of PrEP use. 79.8% of participants achieved early continuation, although the rate was significantly lower among TGW at 56% (Odds Ratio = 0.29; 95% Confidence Interval: 0.21–0.40). Overall PrEP adherence was 96.9%.
"Our study provides evidence that same-day PrEP initiation in Latin America is feasible and safe, with good overall levels of early continuation and adherence," the researchers concluded. "TGW and younger MSM may require differentiated care to improve PrEP continuation."
The study, "Safety, early continuation and compliance of same-day PrEP initiation among MSM and TGW in Brazil, Mexico and Peru: the ImPrEP Study", was presented on Tuesday, July 23, 2019, at NIC 2019 in Mexico City, Mexico.
From: https://www.contagionlive.com/news/imprep-study-sameday-prep-initiation-results-in-good-overall-continuation-among-msm-tgw