No Evidence of Sexual Risk Compensation Following PrEP Initiation Among Heterosexual HIV Serodiscordant Couples in Kenya and Uganda

被引:11
作者
Ortblad, Katrina F. [1 ]
Stalter, Randy M. [1 ,2 ]
Bukusi, Elizabeth A. [1 ,3 ,4 ]
Ngure, Kenneth [5 ]
Mujugura, Andrew [6 ]
Celum, Connie [1 ,7 ]
Baeten, Jared M. [1 ,2 ,7 ]
Heffron, Renee [1 ,7 ]
机构
[1] Univ Washington, Dept Global Hlth, 908 Jefferson St,12th Floor, Seattle, WA 98104 USA
[2] Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA
[3] Univ Washington, Dept Obstet & Gynecol, Seattle, WA 98195 USA
[4] Kenya Govt Med Res Ctr, Ctr Microbiol Res, Nairobi, Kenya
[5] Jomo Kenyatta Univ Agr & Technol, Dept Community Hlth, Nairobi, Kenya
[6] Makerere Univ, Infect Dis Inst, Kampala, Uganda
[7] Univ Washington, Dept Med, Seattle, WA USA
基金
美国国家卫生研究院; 比尔及梅琳达.盖茨基金会;
关键词
PrEP; Sexual risk compensation; Condom use; HIV; Serodiscordant couples; Africa; PREEXPOSURE PROPHYLAXIS USE; ANTIRETROVIRAL PROPHYLAXIS; CONDOM USE; MEN; BEHAVIOR; WOMEN; NEGOTIATION; PREVENTION; BARRIERS; GAY;
D O I
10.1007/s10461-019-02720-4
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Recent studies among men who have sex with men suggest that sexual behaviors associated with risk of sexually transmitted infections increase following initiation of pre-exposure prophylaxis (PrEP) for HIV prevention. We used longitudinal data from HIV-uninfected participants (n=1013) enrolled in an open-label study of PrEP delivered to Ugandan and Kenyan heterosexual HIV serodiscordant couples to understand the association between PrEP initiation and HIV risk-related sexual behaviors among these couples. In the month following PrEP initiation, the mean number of monthly sex acts within couples decreased from 7.9 to 6.9 (mean difference: - 1.1; 95% CI - 1.5, - 0.7) and the proportion of couples having condomless sex decreased from 65% to 32% (percentage point change: - 33%; 95% CI - 37%, - 30%); these behaviors then remained relatively constant over 2 years. We found no evidence of sexual risk compensation following PrEP initiation within African serodiscordant couples. However, roughly a third of couples continued to engage in condomless sex during follow up, emphasizing the importance of continued PrEP use to sustain HIV protection.
引用
收藏
页码:1365 / 1375
页数:11
相关论文
共 36 条
[1]   Sexual behavior of HIV discordant couples after HIV counseling and testing [J].
Allen, S ;
Meinzen-Derr, L ;
Kautzman, M ;
Zulu, I ;
Trask, S ;
Fideli, U ;
Musonda, R ;
Kasolo, F ;
Gao, F ;
Haworth, A .
AIDS, 2003, 17 (05) :733-740
[2]   Quasi-experimental study designs series-paper 7: assessing the assumptions [J].
Baernighausen, Till ;
Oldenburg, Catherine ;
Tugwell, Peter ;
Bommer, Christian ;
Ebert, Cara ;
Barreto, Mauricio ;
Djimeu, Eric ;
Haber, Noah ;
Waddington, Hugh ;
Rockers, Peter ;
Sianesi, Barbara ;
Bor, Jacob ;
Fink, Gunther ;
Valentine, Jeffrey ;
Tanner, Jeffrey ;
Stanley, Tom ;
Sierra, Eduardo ;
Tchetgen, Eric Tchetgen ;
Atun, Rifat ;
Vollmer, Sebastian .
JOURNAL OF CLINICAL EPIDEMIOLOGY, 2017, 89 :53-66
[3]   Antiretroviral Prophylaxis for HIV Prevention in Heterosexual Men and Women [J].
Baeten, J. M. ;
Donnell, D. ;
Ndase, P. ;
Mugo, N. R. ;
Campbell, J. D. ;
Wangisi, J. ;
Tappero, J. W. ;
Bukusi, E. A. ;
Cohen, C. R. ;
Katabira, E. ;
Ronald, A. ;
Tumwesigye, E. ;
Were, E. ;
Fife, K. H. ;
Kiarie, J. ;
Farquhar, C. ;
John-Stewart, G. ;
Kakia, A. ;
Odoyo, J. ;
Mucunguzi, A. ;
Nakku-Joloba, E. ;
Twesigye, R. ;
Ngure, K. ;
Apaka, C. ;
Tamooh, H. ;
Gabona, F. ;
Mujugira, A. ;
Panteleeff, D. ;
Thomas, K. K. ;
Kidoguchi, L. ;
Krows, M. ;
Revall, J. ;
Morrison, S. ;
Haugen, H. ;
Emmanuel-Ogier, M. ;
Ondrejcek, L. ;
Coombs, R. W. ;
Frenkel, L. ;
Hendrix, C. ;
Bumpus, N. N. ;
Bangsberg, D. ;
Haberer, J. E. ;
Stevens, W. S. ;
Lingappa, J. R. ;
Celum, C. .
NEW ENGLAND JOURNAL OF MEDICINE, 2012, 367 (05) :399-410
[4]   Integrated Delivery of Antiretroviral Treatment and Pre-exposure Prophylaxis to HIV-1-Serodiscordant Couples: A Prospective Implementation Study in Kenya and Uganda [J].
Baeten, Jared M. ;
Heffron, Renee ;
Kidoguchi, Lara ;
Mugo, Nelly R. ;
Katabira, Elly ;
Bukusi, Elizabeth A. ;
Asiimwe, Stephen ;
Haberer, Jessica E. ;
Morton, Jennifer ;
Ngure, Kenneth ;
Bulya, Nulu ;
Odoyo, Josephine ;
Tindimwebwa, Edna ;
Hendrix, Craig ;
Marzinke, Mark A. ;
Ware, Norma C. ;
Wyatt, Monique A. ;
Morrison, Susan ;
Haugen, Harald ;
Mujugira, Andrew ;
Donnell, Deborah ;
Celum, Connie .
PLOS MEDICINE, 2016, 13 (08)
[5]  
Baltagi B., 2008, Econometric analysis of panel data
[6]   Does HIV pre-exposure prophylaxis use lead to a higher incidence of sexually transmitted infections? A case-crossover study of men who have sex with men in Los Angeles, California [J].
Beymer, Matthew R. ;
DeVost, Michelle A. ;
Weiss, Robert E. ;
Dierst-Davies, Rhodri ;
Shover, Chelsea L. ;
Landovitz, Raphael J. ;
Beniasians, Corinne ;
Talan, Ali J. ;
Flynn, Risa P. ;
Krysiak, Robyn ;
McLaughlin, Kayla ;
Bolan, Robert K. .
SEXUALLY TRANSMITTED INFECTIONS, 2018, 94 (06) :457-+
[7]   CONDOMLESS GROUP SEX IS ASSOCIATED WITH HIV PRE-EXPOSURE PROPHYLAXIS KNOWLEDGE AND INTEREST UPTAKE: A CROSS-SECTIONAL STUDY OF GAY AND BISEXUAL MEN IN PARIS, FRANCE [J].
Callander, Denton ;
Park, Su Hyun ;
Al-Ajlouni, Yazan A. ;
Schneider, John A. ;
Khan, Maria R. ;
Safren, Steven A. ;
Duncan, Dustin T. .
AIDS EDUCATION AND PREVENTION, 2019, 31 (02) :127-135
[8]   Antiretroviral prophylaxis for HIV infection in injecting drug users in Bangkok, Thailand (the Bangkok Tenofovir Study): a randomised, double-blind, placebo-controlled phase 3 trial [J].
Choopanya, Kachit ;
Martin, Michael ;
Suntharasamai, Pravan ;
Sangkum, Udomsak ;
Mock, Philip A. ;
Leethochawalit, Manoj ;
Chiamwongpaet, Sithisat ;
Kitisin, Praphan ;
Natrujirote, Pitinan ;
Kittimunkong, Somyot ;
Chuachoowong, Rutt ;
Gvetadze, Roman J. ;
McNicholl, Janet M. ;
Paxton, Lynn A. ;
Curlin, Marcel E. ;
Hendrix, Craig W. ;
Vanichseni, Suphak .
LANCET, 2013, 381 (9883) :2083-2090
[9]   Sexual Self-Efficacy and Gender: A Review of Condom Use and Sexual Negotiation Among Young Men and Women in Sub-Saharan Africa [J].
Closson, Kalysha ;
Dietrich, Janan J. ;
Lachowsky, Nathan J. ;
Nkala, Busiwe ;
Palmer, Alexis ;
Cui, Zishan ;
Beksinska, Mags ;
Smit, Jennifer A. ;
Hogg, Robert S. ;
Gray, Glenda ;
Miller, Cari L. ;
Kaida, Angela .
JOURNAL OF SEX RESEARCH, 2018, 55 (4-5) :522-539
[10]   Human Embryonic Stem-Cell Research under Siege - Battle Won but Not the War [J].
Cohen, I. Glenn ;
Adashi, Eli Y. .
NEW ENGLAND JOURNAL OF MEDICINE, 2011, 364 (22) :e48(1)