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Factors Associated with Preferred Pre-Exposure Prophylaxis Dosing Regimen Among Men Who Have Sex with Men in Real-World Settings: A Mixed-Effect Model Analysis

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Abstract

When provided with both choices of pre-exposure prophylaxis (PrEP) in MSM, men may choose to use either method based on their sexual practice. The study objective was to describe the switches between dosing regimens and identify factors that predict choice of a dosing regimen among MSM. We performed a multi-center, observational, prospective PrEP cohort study conducted at three study sites in Taiwan between January 2018 and March 2019. A total of 215 participants made 469 visits. In half of the visits (49.7%), participants reported using on-demand PrEP. There were 36 regimen switches: 20 from daily to on-demand and 16 from on-demand to daily. Among 28 participants who switched regimens, 22 switched regimens once and 6 switched more than once. The frequency of condomless anal sex and a history of post-exposure prophylaxis use were associated with taking PrEP on-demand (p < 0.05). PrEP adherence intervention should be tailored specifically to sexual behavior to increase adherence to PrEP.

Resumen

Cuando se les proporcionan ambas opciones de la profilaxis pre-exposición (PrEP) en HSH, los hombres pueden elegir usar cualquiera de los métodos según su práctica sexual. El objetivo del estudio fue describir los cambios entre los regímenes de dosificación e identificar los factores que predicen la elección del régimen de dosificación entre los HSH. Realizamos un estudio de cohorte prospectivo, observacional y multicéntrico de la PrEP realizado en tres sitios de estudio en Taiwán entre enero de 2018 y marzo de 2019. Un total de 215 participantes contribuyeron con 469 visitas. En la mitad de las visitas (49.7%), los participantes informaron haber usado PrEP a pedido. Hubo 36 cambios de régimen: 20 de diario a pedido y 16 de pedido a diario. Entre los 28 participantes que cambiaron de régimen, 22 cambiaron de régimen una vez y 6 cambiaron más de una vez. La frecuencia del sexo anal sin condón y cualquier uso previo de la PEP fueron asociados con la toma de la PrEP a pedido (p < .05). La intervención de adherencia a la PrEP debe adaptarse específicamente al comportamiento sexual para aumentar la adherencia a la PrEP.

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Acknowledgements

Part of the results was presented as a poster at the 10th International AIDS Conference on HIV Science, Mexico City, Mexico (Abstract Number: TUPEC410). We are grateful to the study participants. We appreciate the Spanish translation of the abstract and keywords by Jorge Soler, PhD, MPH.

Funding

This study was funded by the Taiwan Ministry of Science and Technology (MOST 108-2636-B-006-004, MOST 109-2636-B-006-004).

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Authors and Affiliations

  1. Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Huei-Jiuan Wu, Tsung Yu & Carol Strong

  2. Division of Infectious Diseases, Department of Medicine, Taipei City Hospital Renai Branch, Taipei, Taiwan

    Stephane Wen-Wei Ku

  3. Division of Infectious Diseases, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Chia-Wen Li

  4. Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Nai-Ying Ko

  5. Taiwan Love and Hope Association, Kaohsiung, Taiwan

    Nai-Ying Ko & An-Chun Chung

  6. Healing, Empowerment, Recovery of Chemsex Health Center, Kaohsiung, Taiwan

    Nai-Ying Ko & An-Chun Chung

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  1. Huei-Jiuan Wu
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  2. Stephane Wen-Wei Ku
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Correspondence to Carol Strong.

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The authors declare that they have no conflict of interest.

Ethical Approval

This study protocol was reviewed with exemption and approved by the Institutional Review Board of National Cheng Kung University Hospital (IRB#: B-BR-106-046 and A-BR-107-047).

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Wu, HJ., Ku, S.WW., Li, CW. et al. Factors Associated with Preferred Pre-Exposure Prophylaxis Dosing Regimen Among Men Who Have Sex with Men in Real-World Settings: A Mixed-Effect Model Analysis. AIDS Behav 25, 249–258 (2021). https://doi.org/10.1007/s10461-020-02964-5

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