Human Immunodeficiency Virus (HIV) Seroconversion Among Men Who Have Sex With Men Who Use Event-driven or Daily Oral Pre-exposure Prophylaxis (CohMSM-PrEP): A Multi-country Demonstration Study From West Africa

被引：15

作者：

Laurent, Christian ^{[1
,13
]}

Yaya, Issifou ^{[1
]}

Cuer, Benjamin ^{[1
]}

Sagaon-Teyssier, Luis ^{[2
]}

Mensah, Ephrem ^{[3
]}

Dah, Ter Tiero Elias ^{[4
,5
]}

Coulibaly, Alou ^{[6
]}

Kouame, Malan Jean-Baptiste ^{[7
]}

Peytavin, Gilles ^{[8
,9
]}

Serrano, Laetitia ^{[1
]}

Eubanks, August ^{[2
]}

Traore, Issa ^{[4
]}

Diallo, Fodie ^{[6
]}

Riegel, Lucas ^{[10
]}

Rojas Castro, Daniela ^{[10
]}

Dagnra, Claver A. ^{[11
]}

Anoma, Camille ^{[7
]}

Vuylsteke, Bea ^{[12
]}

Keita, Bintou Dembele ^{[6
]}

Spire, Bruno ^{[2
]}

机构：

[1] Univ Montpellier, Inserm, TransVIHMI, IRD, Montpellier, France

[2] Aix Marseille Univ, Inserm, IRD, SESSTIM Sci Econ & Sociales St & Traitement Inform, Marseille, France

[3] Espoir Vie Togo, Lome, Togo

[4] Assoc African Solidarite, Ouagadougou, Burkina Faso

[5] Univ Ouahigouya, UFR Sci Sante, Ouahigouya, Burkina Faso

[6] ARCAD Sante PLUS, Bamako, Mali

[7] Espace Confiance, Abidjan, Cote Ivoire

[8] Univ Paris Cite, AP HP, Inserm, Lab Pharmacol,UMR 1137,IAME, Paris, France

[9] Hop Bichat Claude Bernard, Paris, France

[10] Coalit PLUS, Lab Rech Communautaire, Pantin, France

[11] Univ Lome, BIOLIM, Lome, Togo

[12] Inst Trop Med, Publ Hlth, Antwerp, Belgium

[13] Unite TransVIHMI, Inst Rech Dev, 911 Ave Agropolis,BP 64501, F-34394 Montpellier 5, France

来源：

CLINICAL INFECTIOUS DISEASES | 2023年 / 77卷 / 04期

关键词：

HIV; PrEP; seroconversion; MSM; Africa; SAFETY;

D O I：

10.1093/cid/ciad221

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background Data on human immunodeficiency virus (HIV) seroconversion among men who have sex with men (MSM) using pre-exposure prophylaxis (PrEP) in West Africa are needed. This study aimed to document HIV seroconversion and associated determinants, PrEP adherence, plasma drug concentrations, and HIV drug resistance in MSM using event-driven or daily PrEP in Burkina Faso, Cote d'Ivoire, Mali, and Togo. Methods A prospective cohort study was conducted in 2017-2021 among HIV-seronegative MSM aged 18 or over who were at high risk of HIV infection. Participants could choose between event-driven and daily PrEP, switch regimens, and discontinue or restart PrEP. The determinants of HIV incidence were investigated using a multivariate mixed-effects Poisson regression analysis. Results A total of 647 participants were followed for a total time of 1229.3 person-years. Of 5371 visits, event-driven PrEP was chosen in 3873 (72.1%), and daily PrEP in 1400 (26.1%). HIV incidence was 2.4 per 100 person-years (95% confidence interval [CI] 1.5-3.6) for event-driven PrEP, and 0.6 per 100 person-years (95% CI .1-2.3) for daily PrEP (adjusted incidence rate ratio 4.40, 95% CI 1.00-19.36, P = .050). Adequate adherence was lower with event-driven than daily PrEP (44.3% vs 74.9%, P < .001). Plasma drug concentrations were undetectable in 92 (97.9%) of the 94 measures taken for 23 participants who seroconverted. Only 1 participant had resistance to PrEP drugs. Conclusions HIV seroconversions mainly occurred in participants who chose event-driven PrEP. The study's data highlighted major difficulties with adherence to this regimen. Improving adherence to event-driven PrEP constitutes a major research and public health priority in this context. Human immunodeficiency virus seroconversions mainly occurred in West African men who have sex with men who chose event-driven pre-exposure prophylaxis. The study's pharmacological data, self-reported quantitative data and interview discourses highlighted major difficulties with adherence.

引用

页码：606 / 614

页数：9