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MSM at Highest Risk for HIV Acquisition Express Greatest Interest and Preference for Injectable Antiretroviral PrEP Compared to Daily, Oral Medication

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Abstract

Men who have sex with men (MSM) account for nearly 70% of new HIV diagnoses, with young black MSM at the highest risk for infection in the United States. Pre-exposure prophylaxis (PrEP) can decrease HIV acquisition in at-risk individuals by over 90%. However, therapeutic efficacy requires a daily pill, posing adherence challenges. Experimental modalities, including injectable PrEP given once every 2 months, may improve adherence among those most in need. To assess interest in and preference for injectable PrEP, an online survey was mounted on two popular MSM sexual networking apps. Differences by age, race, and other characteristics were examined using multinomial logistic regressions. Of 4638 respondents, 73% expressed interest in injectable PrEP and 47% indicated they would prefer an injection (compared to 17% who prefer a daily pill and 36% who were unsure). Within this sample, interest in and preference for injectable PrEP was highest among MSM at highest risk for HIV infection (i.e., younger age groups, racial/ethnic minorities, those with risker sexual behavior). As a result, if proven effective in clinical trials, injectable PrEP has the potential to reduce social disparities in HIV transmission among MSM.

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References

  1. Centers for Disease Control and Prevention. HIV surveillance report; vol. 27. 2016 Nov. https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-2015-vol-27.pdf. Accessed March 2017.

  2. Centers for Disease Control and Prevention. HIV in the United States: at a glance. 2016 Dec. https://www.cdc.gov/hiv/statistics/overview/ataglance.html. Accessed March 2017.

  3. Hergenrather KC, Emmanuel D, Durant S, Rhodes SD. Enhancing HIV prevention among young men who have sex with men: a systematic review of HIV behavioral interventions for young gay and bisexual men. AIDS Educ Prev. 2016;28(3):252–71.

    Article  PubMed  Google Scholar 

  4. U.S. Public Health Service. Preexposure prophylaxis for the prevention of HIV infection in the United States: a clinical practice guideline. 2014 May. https://www.cdc.gov/hiv/pdf/prepguidelines2014.pdf. Accessed March 2017.

  5. World Health Organization. Oral pre-exposure prophylaxis for preventing the acquisition of HIV. In: Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach, 2nd ed. 2016 Jun. http://www.who.int/hiv/pub/arv/chapter3.pdf?ua=1. Accessed March 2017.

  6. Grant RM, Lama JR, Anderson PL, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010;363(27):2587–99.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Molina JM, Capitant C, Spire B, et al. On-demand preexposure prophylaxis in men at high risk for HIV-1 infection. N Engl J Med. 2015;373(23):2237–46.

    Article  CAS  PubMed  Google Scholar 

  8. Smith DK, Van Handel M, Wolitski RJ, et al. Vital signs: estimated percentages and numbers of adults with indications for preexposure prophylaxis to prevent HIV acquisition—United States, 2015. Morb Mortal Wkly Rep. 2015;64(46):1291–5.

    Article  Google Scholar 

  9. Krakower DS, Mimiaga MJ, Rosenberger JG, et al. Limited awareness and low immediate uptake of pre-exposure prophylaxis among men who have sex with men using an internet social networking site. PLoS ONE. 2012;7(3):e33119.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Bush S, Magnuson D, Rawlings MK, Hawkins T, McCallister S, Mera Giler R. Racial characteristics of FTC/TDF for pre-exposure prophylaxis users in the US. Presented at: ASM Microbe; 2016 Jun; Boston.

  11. Hosek SG, Rudy B, Landovitz R, et al. An HIV preexposure prophylaxis demonstration project and safety study for young MSM. J Acquir Immune Defic Syndr. 2017;74(1):21–9.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Markowitz M, Frank I, Grant R, et al. ECLAIR: Phase 2A safety and PK study of cabotegravir LA in HIV-uninfected men. In: Conference on retroviruses and opportunistic infections (CROI), 22–25 February 2016, Boston. Abstract 106.

  13. Landovitz R, Li S, Grinsztejn B, et al. Safety, tolerability and pharmacokinetics of long-acting injectable cabotegravir in low-risk HIV-uninfected women and men: HPTN 077. International AIDS Society (IAS), 2017, Paris, France. Abstract 5481.

  14. U.S. National Institute of Allergy and Infectious Diseases. HPTN 083: a phase 2b/3 double blind safety and efficacy study of injectable cabotegravir compared to daily oral tenofovir disoproxil fumarate/emtricitabine (TDF/FTC), for pre-exposure prophylaxis in HIV-uninfected cisgender men and transgender women who have sex with men. 2016 Feb. https://www.hptn.org/sites/default/files/2016-05/HPTN%20083-Final%20Version%201.0-02Feb2016.pdf. Accessed March 2017.

  15. Meyers K, Rodriguez K, Moeller RW, Gratch I, Markowitz M, Halkitis PN. High interest in a long-acting injectable formulation of pre-exposure prophylaxis for HIV in young men who have sex with men in NYC: a P18 cohort substudy. PLoS ONE. 2014;9(12):e114700.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Greene GJ, Swann G, Fought AJ, et al. Preferences for long-acting pre-exposure prophylaxis (PrEP), daily oral PrEP, or condoms for HIV prevention among U.S. men who have sex with men. AIDS Behav. 2017;21(5):1336–49.

    Article  PubMed  Google Scholar 

  17. Parsons JT, Rendina HJ, Whitfield TH, Grov C. Familiarity with and preferences for oral and long-acting injectable HIV pre-exposure prophylaxis (PrEP) in a national sample of gay and bisexual men in the U.S. AIDS Behav. 2016;20(7):1390–9.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Mimiaga MJ, Noonan E, Donnell D, et al. Childhood sexual abuse is highly associated with HIV risk-taking behavior and infection among MSM in the EXPLORE Study. J Acquir Immune Defic Syndr. 2009;51(3):340–8.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Biello KB, Hosek S, Drucker MT, et al. Preferences for injectable PrEP among young U.S. cisgender men and transgender women and men who have sex with men. Arch Sex Behav. 2017.

  20. Liu AY, Cohen SE, Vittinghoff E. Preexposure prophylaxis for HIV infection integrated with municipal- and community-based sexual health services. JAMA Intern Med. 2016;176(1):75–84.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Garcia J, Colson PW, Parker C, Hirsch JS. Passing the baton: community-based ethnography to design a randomized clinical trial on the effectiveness of oral pre-exposure prophylaxis for HIV prevention among black men who have sex with men. Contemp Clin Trials. 2015;45(Pt B):244–51.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Golub SA, Gamarel KE, Surace A. Demographic differences in PrEP-related stereotypes: implications for implementation. AIDS Behav. 2017;21(5):1229–35.

    Article  PubMed  Google Scholar 

  23. Sullivan PS, Khosropour CM, Luisi N, et al. Bias in online recruitment and retention of racial and ethnic minority men who have sex with men. J Med Internet Res. 2011;13(2):e38.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Biello KB, Rosenberger JG, Novak DS, Robertson AM, Mayer KH, Mimiaga MJ. Epidemiology of sexual health in the virtual environment: a multinational online survey of Spanish- and Portuguese-speaking men who use an internet sexual networking site. AIDS Behav. 2014;18(9):1675–85.

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors wish to acknowledge the altruism of the participants and the assistance of the staff of Online Buddies, Inc. in mounting this web survey. This study was supported by an unrestricted research grant from ViiV Healthcare.

Funding

This study was supported by ViiV Healthcare, Inc. Additional support for Dr. Kenneth H. Mayer’s role was provided by the Harvard University Center for AIDS Research (CFAR), an NIH funded program (Grant Number P30 AI060354), which is supported by the following NIH Co-Funding and Participating Institutes and Centers: NIAID, NCI, NICHD, NHLBI, NIDA, NIMH, NIA, NIDDK, NIGMS, NIMHD, FIC, and OAR. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Departments of Behavioral & Social Sciences and Epidemiology, Brown University School of Public Health, Providence, RI, USA

    Katie B. Biello & Matthew J. Mimiaga

  2. Center for Health Equity Research, Brown University School of Public Health, Providence, RI, USA

    Katie B. Biello, Matthew J. Mimiaga & Christopher M. Santostefano

  3. Fenway Health, Fenway Institute, Boston, MA, USA

    Katie B. Biello, Matthew J. Mimiaga & Kenneth H. Mayer

  4. Online Buddies, Inc., Cambridge, MA, USA

    David S. Novak

  5. Division of Infectious Diseases, Harvard Medical School/Beth Israel Deaconess Medical Center, Boston, MA, USA

    Kenneth H. Mayer

  6. Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, USA

    Kenneth H. Mayer

Authors
  1. Katie B. Biello
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  2. Matthew J. Mimiaga
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  3. Christopher M. Santostefano
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  4. David S. Novak
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  5. Kenneth H. Mayer
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Corresponding author

Correspondence to Katie B. Biello.

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Conflicts of interest

Dr. Kenneth H. Mayer has received unrestricted research grants from ViiV Healthcare, Inc. and Gilead Sciences. The remaining authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained electronically from all individual participants included in the study. A waiver of documentation of consent was approved by the Fenway Health Institutional Review Board.

Additional information

HIV Research for Prevention 2016: AIDS Vaccine, Microbicide and ARV-based Prevention Science (HIVR4P), Chicago, IL.

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Biello, K.B., Mimiaga, M.J., Santostefano, C.M. et al. MSM at Highest Risk for HIV Acquisition Express Greatest Interest and Preference for Injectable Antiretroviral PrEP Compared to Daily, Oral Medication. AIDS Behav 22, 1158–1164 (2018). https://doi.org/10.1007/s10461-017-1972-6

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  • DOI: https://doi.org/10.1007/s10461-017-1972-6

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