High Interest in Preexposure Prophylaxis Among Men Who Have Sex With Men at Risk for HIV Infection: Baseline Data From the US PrEP Demonstration Project

作者：Cohen Stephanie E^*; Vittinghoff Eric; Bacon Oliver; Doblecki Lewis Susanne; Postle Brian S; Feaster Daniel J; Matheson Tim; Trainor Nikole; Blue Robert W; Estrada Yannine; Coleman Megan E; Elion Richard; Castro Jose G; Chege Wairimu; Philip Susan S; Buchbinder Susan; Kolber Michael A; Liu Albert Y

来源：JAIDS: Journal of Acquired Immune Deficiency Syndromes , 2015, 68(4): 439-448.

• preexposure prophylaxis
• HIV prevention
• men who have sex with men
• sexually transmitted diseases
• implementation

Background: Preexposure prophylaxis (PrEP) is the first biomedical intervention with proven efficacy to reduce HIV acquisition in men who have sex with men (MSM) and transgender women. Little is known about levels of interest and characteristics of individuals who elect to take PrEP in real-world clinical settings.
Methods: The US PrEP Demonstration Project is a prospective open-label cohort study assessing PrEP delivery in municipal sexually transmitted disease clinics in San Francisco and Miami and a community health center in Washington, DC. HIV-uninfected MSM and transgender women seeking sexual health services at participating clinics were assessed for eligibility and offered up to 48 weeks of emtricitabine/tenofovir for PrEP. Predictors of enrollment were assessed using a multivariable Poisson regression model, and characteristics of enrolled participants are described.
Results: Of 1069 clients assessed for participation, 921 were potentially eligible and 557 (60.5%) enrolled. In multivariable analyses, participants from Miami (adjusted Relative Risk [aRR]: 1.53; 95% confidence interval [CI]: 1.33 to 1.75) or DC (aRR: 1.33; 95% CI: 1.2 to 1.47), those who were self-referred (aRR: 1.48; 95% CI: 1.32 to 1.66), those with previous PrEP awareness (aRR: 1.56; 95% CI: 1.05 to 2.33), and those reporting >1 episode of anal sex with an HIV-infected partner in the last 12 months (aRR: 1.20; 95% CI: 1.09 to 1.33) were more likely to enroll. Almost all (98%) enrolled participants were MSM, and at baseline, 63.5% reported condomless receptive anal sex in the previous 3 months.
Conclusions: Interest in PrEP is high among a diverse population of MSM at risk for HIV infection when offered in sexually transmitted disease and community health clinics.

• 出版日期2015-4-1