Change in sexual risk behaviour after 6 months of pre-exposure prophylaxis use: results from the Amsterdam pre-exposure prophylaxis demonstration project
- 17 July 2018
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in AIDS
- Vol. 32 (11), 1527-1532
- https://doi.org/10.1097/QAD.0000000000001874
Abstract
Objective: HIV pre-exposure prophylaxis (PrEP) use may lead to higher STI incidence via behavioural risk compensation. We examined changes in sexual behaviour between baseline and 6 months after PrEP initiation among MSM and transgender women (TGW). Design: Prospective, open-label demonstration study at a large sexually transmitted infection (STI) clinic in Amsterdam, the Netherlands. Methods: Participants answered questions about sexual behaviour in the preceding 3 months, including number of anal sex partners and frequency of anal sex with and without condom by partner type and were tested for STI. Sexual behaviour at baseline was compared with 6 months after PrEP initiation using Wilcoxon signed rank tests. Logistic regression was used to identify factors associated with an increase in receptive condomless anal sex acts (rCASa) with casual partners. Results: Data were available for 328 (99%) MSM and 2 (1%) TGW. The number of receptive and insertive condomless anal sex acts (CASa) increased (baseline: median 11, interquartile range 4-23; 6 months: median 14, interquartile range 6-26, P<0.001), whereas the number of anal sex partners (P = 0.2) and anal sex acts (P = 0.8) remained unchanged. Prevalence of STI was stable. Older age, prior engagement in chemsex, recent use of postexposure prophylaxis and choosing a daily PrEP regimen at baseline were associated with an increase in rCASa with casual partners. Conclusion: Over the first 6 months after initiation of PrEP, an increase in insertive and receptive CASa with casual partners was observed. Long-term follow-up data are needed and STI incidence needs to be closely monitored. Copyright (C) 2018 Wolters Kluwer Health, Inc. All rights reserved.This publication has 14 references indexed in Scilit:
- Men who have sex with men more often chose daily than event‐driven use of pre‐exposure prophylaxis: baseline analysis of a demonstration study in AmsterdamJournal of the International AIDS Society, 2018
- Sexually transmitted infections: challenges aheadThe Lancet Infectious Diseases, 2017
- Medication adherence, condom use and sexually transmitted infections in Australian preexposure prophylaxis usersAIDS, 2017
- Behavioral Changes Following Uptake of HIV Pre-exposure Prophylaxis Among Men Who Have Sex with Men in a Clinical SettingAIDS and Behavior, 2017
- Preexposure Prophylaxis for HIV Infection Integrated With Municipal- and Community-Based Sexual Health ServicesJAMA Internal Medicine, 2016
- On-Demand Preexposure Prophylaxis in Men at High Risk for HIV-1 InfectionThe New England Journal of Medicine, 2015
- Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trialThe Lancet, 2015
- No New HIV Infections With Increasing Use of HIV Preexposure Prophylaxis in a Clinical Practice Setting: Figure 1.Clinical Infectious Diseases, 2015
- Uptake of pre-exposure prophylaxis, sexual practices, and HIV incidence in men and transgender women who have sex with men: a cohort studyThe Lancet Infectious Diseases, 2014
- HIV transmission risk through anal intercourse: systematic review, meta-analysis and implications for HIV preventionInternational Journal of Epidemiology, 2010