Skip to main content

Advertisement

SpringerLink
Log in

Rate and Predictors of Ineffective HIV Protection in African Men Who Have Sex with Men Taking Pre-Exposure Prophylaxis

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

We investigated the rate and predictors of ineffective HIV protection in men who have sex with men (MSM) taking pre-exposure prophylaxis (PrEP) in a prospective cohort study from November 2017 to November 2020 in Mali, Côte d’Ivoire, Burkina Faso, and Togo. MSM had to be 18 years or older and at high risk of HIV infection to participate. They also received a comprehensive sexual health prevention package, including PrEP, in community-based clinics as part of the cohort study. Using socio-behavioral/clinical data, HIV protection during their most recent anal intercourse with a male partner was categorized as effective or ineffective (i.e., incorrect PrEP adherence and no condom use). Seventeen percent (500/2839) of intercourses were ineffectively protected for the 520 study participants. Predictors of ineffective HIV protection included being an event-driven user with financial difficulties, having a high alcohol misuse score, and not being a member of a community association. PrEP programs in West Africa must be tailored to socially vulnerable MSM who struggle to adopt PrEP.

Resumen

En este artículo hemos investigado la proporción y los factores predictivos de la protección ineficaz de VIH en un grupo de hombres, que tienen sexo con hombres (HSH) y que usan la profilaxis pre-exposición (PrEP). Se usaron los datos de un estudio de cohorte prospectivo realizado entre noviembre del 2017 y noviembre del 2020 en Mali, Costa de Marfil, Burkina Faso y Togo. Los participantes son HSH, de 18 años o más, y con alto riesgo de contaminación por el VIH. Estos han recibido un paquete completo de prevención en salud sexual incluyendo la PrEP en clínicas comunitarias como parte del estudio de cohorte. La protección contra el VIH durante la última relación sexual anal con un hombre fue categorizada como eficaz o ineficaz a partir de datos socio-comportamentales/clínicos (i.e. adhesión incorrecta à la PrEP y no utilización del condón). Concerniente a 520 participantes, 17% (500/2839) de las relaciones sexuales fueron protegidas de manera ineficaz. Entre los factores predictivos de la protección ineficaz contra el VIH se encuentran, el uso intermitente de la PrEP asociado a una situación financiera difícil, el consumo de alcohol y no ser miembro de una asociación comunitaria. Los programas de PrEP en África del Oeste, deben adaptarse a los HSH más vulnerables quienes podrían tener más dificultad para adoptar la PrEP.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data Availability

The datasets generated and/or analyzed during the current study are not publicly available, but are available from the corresponding author on reasonable request.

Code Availability

The code generated during and/or analyzed during the current study are available from the corresponding author on request.

References

  1. UNAIDS. 2020 Global AIDS update—seizing the moment—tackling entrenched inequalities to end epidemics [Internet]. 2020 [cited 2021 Apr 14]. Available from: https://www.unaids.org/sites/default/files/media_asset/2020_global-aids-report_en.pdf

  2. UNAIDS. AIDSinfo | UNAIDS [Internet]. 2020 [cited 2021 Apr 14]. Available from: https://aidsinfo.unaids.org/

  3. AVAC. Global PrEP enrollee tracker. 2020; Available from: https://www.prepwatch.org/resource/global-prep-tracker/

  4. World Health Organization. Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations. [Internet]. 2014 [cited 2021 Apr 14]. Available from: http://www.who.int/hiv/pub/guidelines/keypopulations/en/

  5. World Health Organization. What’s the 2+1+1? EVENT-driven oral pre-exposure prophylaxis to prevent HIV for men who have sex with men: update to who’s recommendation on oral prep [Internet]. 2019. Available from: https://apps.who.int/iris/bitstream/handle/10665/325955/WHO-CDS-HIV-19.8-eng.pdf?ua=1

  6. Djomand G, Quaye S, Sullivan PS. HIV epidemic among key populations in west Africa: Curr Opin HIV AIDS. 2014;9(5):506–13.

    PubMed  PubMed Central  Google Scholar 

  7. Smith AD, Tapsoba P, Peshu N, Sanders EJ, Jaffe HW. Men who have sex with men and HIV/AIDS in sub-Saharan Africa. The Lancet. 2009;374(9687):416–22.

    Article  Google Scholar 

  8. Kushwaha S, Lalani Y, Maina G, Ogunbajo A, Wilton L, Agyarko-Poku T, et al. “But the moment they find out that you are MSM…”: a qualitative investigation of HIV prevention experiences among men who have sex with men (MSM) in Ghana’s health care system. BMC Public Health. 2017;17(1):770.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Ogunbajo A, Kershaw T, Kushwaha S, Boakye F, Wallace-Atiapah N-D, Nelson LE. Barriers, motivators, and facilitators to engagement in HIV care among HIV-infected Ghanaian men who have sex with men (MSM). AIDS Behav. 2018;22(3):829–39.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Mendos LR. State sponsored homophobia 2019. International lesbian, gay, bisexual, trans and intersex association (ILGA World) [Internet]. 2019 Mar. Available from: https://ilga.org/downloads/ILGA_State_Sponsored_Homophobia_2019.pdf

  11. Beyrer C, Baral SD, van Griensven F, Goodreau SM, Chariyalertsak S, Wirtz AL, et al. Global epidemiology of HIV infection in men who have sex with men. Lancet Lond Engl. 2012;380(9839):367–77.

    Article  Google Scholar 

  12. Aho J, Hakim A, Vuylsteke B, Semde G, Gbais HG, Diarrassouba M, et al. Exploring risk behaviors and vulnerability for HIV among men who have sex with men in Abidjan, Cote d’Ivoire: poor knowledge, homophobia and sexual violence. PloS One. 2014;9(6):e99591.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Abara WE, Garba I. HIV epidemic and human rights among men who have sex with men in sub-Saharan Africa: implications for HIV prevention, care, and surveillance. Glob Public Health. 2017;12(4):469–82.

    Article  PubMed  Google Scholar 

  14. Schwartz SR, Nowak RG, Orazulike I, Keshinro B, Ake J, Kennedy S, et al. The immediate effect of the same-sex marriage prohibition Act on stigma, discrimination, and engagement on HIV prevention and treatment services in men who have sex with men in Nigeria: analysis of prospective data from the TRUST cohort. Lancet HIV. 2015;2(7):e299-306.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Makofane K, Gueboguo C, Lyons D, Sandfort T. Men who have sex with men inadequately addressed in African AIDS national strategic plans. Glob Public Health. 2013;8(2):129–43.

    Article  PubMed  Google Scholar 

  16. Duvall S, Irani L, Compaoré C, Sanon P, Bassonon D, Anato S, et al. Assessment of policy and access to HIV prevention, care, and treatment services for men who have sex with men and for sex workers in Burkina Faso and Togo. J Acquir Immune Defic Syndr. 2015;68(Suppl 2):S189–97.

    Article  PubMed  Google Scholar 

  17. Cáceres CF, Koechlin F, Goicochea P, Sow P-S, O’Reilly KR, Mayer KH, et al. The promises and challenges of pre-exposure prophylaxis as part of the emerging paradigm of combination HIV prevention. J Int AIDS Soc. 2015;18(4 Suppl 3):19949.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Baeten JM, Haberer JE, Liu AY, Sista N. Preexposure prophylaxis for HIV prevention: where have we been and where are we going? JAIDS J Acquir Immune Defic Syndr. 2013;63:S122–9.

    Article  PubMed  Google Scholar 

  19. AVAC. Ongoing and Planned Oral PrEP Studies [Internet]. Ongoing and Planned Oral PrEP Studies. 2019 [cited 2019 Dec 18]. Available from: https://www.avac.org/resource/ongoing-and-planned-prep-demonstration-and-implementation-studies

  20. Laurent C, Keita BD, Yaya I, Guicher GL, Sagaon-Teyssier L, Agboyibor MK, et al. HIV pre-exposure prophylaxis for men who have sex with men in West Africa: a multicountry demonstration study. Lancet HIV. 2021;8(7):e420–8.

    Article  PubMed  Google Scholar 

  21. Okafor CN, Gorbach PM, Ragsdale A, Quinn B, Shoptaw S. Correlates of Preexposure Prophylaxis (PrEP) use among men who have sex with men (MSM) in Los Angeles. California J Urban Health. 2017;94(5):710–5.

    Article  PubMed  Google Scholar 

  22. Wheeler DP, Fields SD, Beauchamp G, Chen YQ, Emel LM, Hightow‐Weidman L, et al. Pre‐exposure prophylaxis initiation and adherence among Black men who have sex with men (MSM) in three US cities: results from the HPTN 073 study. J Int AIDS Soc [Internet]. 2019 Feb 15 [cited 2021 Apr 29]. 22(2). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6376611/

  23. Holloway I, Dougherty R, Gildner J, Beougher SC, Pulsipher C, Montoya JA, et al. PrEP uptake, adherence, and discontinuation among California YMSM using geosocial networking applications. J Acquir Immune Defic Syndr. 2017;74(1):15–20.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Whitfield THF, John SA, Rendina HJ, Grov C, Parsons JT. Why I quit pre-exposure prophylaxis (PrEP)? A mixed-method study exploring reasons for PrEP discontinuation and potential re-initiation among gay and bisexual men. AIDS Behav. 2018;22(11):3566–75.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Grant RM, Lama JR, Anderson PL, McMahan V, Liu AY, Vargas L, 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 

  26. Thigpen MC, Kebaabetswe PM, Paxton LA, Smith DK, Rose CE, Segolodi TM, et al. Antiretroviral preexposure prophylaxis for heterosexual HIV transmission in Botswana. N Engl J Med. 2012;367(5):423–34.

    Article  CAS  PubMed  Google Scholar 

  27. Choopanya K, Martin M, Suntharasamai P, Sangkum U, Mock PA, Leethochawalit M, et al. 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. The Lancet. 2013;381(9883):2083–90.

    Article  Google Scholar 

  28. Peng P, Su S, Fairley CK, Chu M, Jiang S, Zhuang X, et al. A Global estimate of the acceptability of pre-exposure prophylaxis for HIV among men who have sex with men: a systematic review and meta-analysis. AIDS Behav. 2018;22(4):1063–74.

    Article  PubMed  Google Scholar 

  29. Tangmunkongvorakul A, Chariyalertsak S, Amico KR, Saokhieo P, Wannalak V, Sangangamsakun T, et al. Facilitators and barriers to medication adherence in an HIV prevention study among men who have sex with men in the iPrEx study in Chiang Mai. Thailand AIDS Care. 2013;25(8):961–7.

    Article  PubMed  Google Scholar 

  30. King HL, Keller SB, Giancola MA, Rodriguez DA, Chau JJ, Young JA, et al. Pre-exposure prophylaxis accessibility research and evaluation (PrEPARE study). AIDS Behav. 2014;18(9):1722–5.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Di Ciaccio M, Sagaon-Teyssier L, Protière C, Mimi M, Suzan-Monti M, Meyer L, et al. Impact of HIV risk perception on both pre-exposure prophylaxis and condom use. J Health Psychol. 2019;24:135910531988392.

    Google Scholar 

  32. Dah TTE, Yaya I, Sagaon-Teyssier L, Coulibaly A, Kouamé MJ-B, Agboyibor MK, et al. Adherence to quarterly HIV prevention services and its impact on HIV incidence in men who have sex with men in West Africa (CohMSM ANRS 12324—Expertise France). BMC Public Health. 2021;21(1):972.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Bradley KA, DeBenedetti AF, Volk RJ, Williams EC, Frank D, Kivlahan DR. AUDIT-C as a brief screen for alcohol misuse in primary care. Alcohol Clin Exp Res. 2007;31(7):1208–17.

    Article  PubMed  Google Scholar 

  34. Molina J-M, Capitant C, Spire B, Pialoux G, Cotte L, Charreau I, 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 

  35. Mutua G, Sanders E, Mugo P, Anzala O, Haberer JE, Bangsberg D, et al. Safety and adherence to intermittent pre-exposure prophylaxis (PrEP) for HIV-1 in African men who have sex with men and female sex workers. PLoS ONE. 2012;7(4):e33103.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Molina J-M, Charreau I, Spire B, Cotte L, Chas J, Capitant C, et al. Efficacy, safety, and effect on sexual behaviour of on-demand pre-exposure prophylaxis for HIV in men who have sex with men: an observational cohort study. Lancet HIV. 2017;4(9):e402–10.

    Article  PubMed  Google Scholar 

  37. Di Ciaccio M, Sagaon-Teyssier L, Mimi M, Suzan-Monti M, Protiere C, Rojas Castro D, et al. Changes in Sexual Behaviors in Men Who Have Sex with Men: A Comparison Between the Double-Blind and Open-Label Extension Phases of the ANRS-IPERGAY Trial. AIDS Behav [Internet]. 2020 Apr 18 [cited 2020 Jul 9]. Available from: http://link.springer.com/https://doi.org/10.1007/s10461-020-02864-8

  38. Gafos M, White D, Clarke A, Apea V, Brodnicki E, Mackie N, et al. Adherence intentions, long-term adherence and HIV acquisition among PrEP users in the PROUD open-label randomised control trial of PrEP in England [Internet]. 2017 [cited 2020 Jun 16]. Available from: http://www.natap.org/2017/IAS/IAS_55.htm

  39. Hosek SG, Siberry G, Bell M, Lally M, Kapogiannis B, Green K, et al. The acceptability and feasibility of an HIV preexposure prophylaxis (PrEP) trial with young men who have sex with men. J Acquir Immune Defic Syndr. 2013;62(4):447–56.

    Article  PubMed  Google Scholar 

  40. Van der Elst EM, Mbogua J, Operario D, Mutua G, Kuo C, Mugo P, et al. High acceptability of HIV pre-exposure prophylaxis but challenges in adherence and use: qualitative insights from a phase I trial of intermittent and daily PrEP in at-risk populations in Kenya. AIDS Behav. 2013;17(6):2162–72.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Scott HM, Spinelli M, Vittinghoff E, Morehead-Gee A, Hirozawa A, James C, et al. Racial/ethnic and HIV risk category disparities in preexposure prophylaxis discontinuation among patients in publicly funded primary care clinics. AIDS Lond Engl. 2019;33(14):2189–95.

    Article  Google Scholar 

  42. Liu AY, Cohen SE, Vittinghoff E, Anderson PL, Doblecki-Lewis S, Bacon O, et al. 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 

  43. Sørensen K, Van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z, et al. Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health. 2012;25(12):80.

    Article  Google Scholar 

  44. Govindasamy D, Ford N, Kranzer K. Risk factors, barriers and facilitators for linkage to antiretroviral therapy care: a systematic review. AIDS. 2012;26(16):2059–67.

    Article  CAS  PubMed  Google Scholar 

  45. Lea T, Ryan D, Prestage G, Zablotska I, Mao L, de Wit J, et al. Alcohol use among a community-based sample of gay men: correlates of high-risk use and implications for service provision. Drug Alcohol Rev. 2015;34(4):349–57.

    Article  PubMed  Google Scholar 

  46. Vanable PA, McKirnan DJ, Buchbinder SP, Bartholow BN, Douglas JM, Judson FN, et al. Alcohol use and high-risk sexual behavior among men who have sex with men: the effects of consumption level and partner type. Health Psychol Off J Div Health Psychol Am Psychol Assoc. 2004;23(5):525–32.

    Google Scholar 

  47. Woolf SE, Maisto SA. Alcohol use and risk of HIV infection among men who have sex with men. AIDS Behav. 2009;13(4):757–82.

    Article  PubMed  Google Scholar 

  48. Wolitski RJ, Stall R, Valdiserri RO. Unequal Opportunity: Health Disparities Affecting Gay and Bisexual Men in the United States. Oxford: Oxford University Press; 2008. p. 415.

    Google Scholar 

  49. De Boni RB, Machado IK, De Vasconcellos MTL, Hoagland B, Kallas EG, Madruga JV, et al. Syndemics among individuals enrolled in the PrEP Brasil Study. Drug Alcohol Depend. 2018;1(185):168–72.

    Article  Google Scholar 

  50. Tan DHS, Leon-Carlyle M, Mills R, Moses E, Carvalhal A. Self-administered screening for syndemic mental health problems should be routinely implemented among MSM PrEP users. J Gay Lesbian Ment Health. 2016;20(1):13–20.

    Article  CAS  Google Scholar 

  51. World Health Organization. Global status report on alcohol and health 2018. [Internet]. 2018. Available from: https://www.who.int/publications/i/item/9789241565639

  52. Lama TP, Kumoji EK, Ketlogetswe D, Anderson M, Brahmbhatt H. Alcohol consumption and risky sexual behavior among persons attending alcohol consumption venues in Gaborone, Botswana. Prev Sci Off J Soc Prev Res. 2016;17(2):227–36.

    Article  Google Scholar 

  53. Sileo K, Kintu M, Chanes-Mora P, Kiene S. “Such behaviors are not in my home village, I got them here”: a qualitative study of the influence of contextual factors on alcohol and HIV risk behaviors in a fishing community on Lake Victoria. Uganda AIDS Behav. 2016;20(3):537–47.

    Article  PubMed  Google Scholar 

  54. Chersich MF, Rees HV. Causal links between binge drinking patterns, unsafe sex and HIV in South Africa: its time to intervene. Int J STD AIDS. 2010;21(1):2–7.

    Article  CAS  PubMed  Google Scholar 

  55. Shuper PA, Joharchi N, Bogoch II, Loutfy M, Crouzat F, El-Helou P, et al. Alcohol consumption, substance use, and depression in relation to HIV Pre-Exposure Prophylaxis (PrEP) nonadherence among gay, bisexual, and other men-who-have-sex-with-men. BMC Public Health [Internet]. 2020 Nov 25 [cited 2021 Mar 18], 20. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7706215/

  56. Mugo PM, Sanders EJ, Mutua G, van der Elst E, Anzala O, Barin B, et al. Understanding adherence to daily and intermittent regimens of oral HIV pre-exposure prophylaxis among men who have sex with men in Kenya. AIDS Behav. 2015;19(5):794–801.

    Article  PubMed  Google Scholar 

  57. Haberer JE, Baeten JM, Campbell J, Wangisi J, Katabira E, Ronald A, et al. Adherence to antiretroviral prophylaxis for HIV prevention: a substudy cohort within a clinical trial of serodiscordant couples in East Africa. PLoS Med. 2013;10(9):e1001511.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Pronyk PM, Harpham T, Morison LA, Hargreaves JR, Kim JC, Phetla G, et al. Is social capital associated with HIV risk in rural South Africa? Soc Sci Med. 2008;66(9):1999–2010.

    Article  PubMed  Google Scholar 

  59. Ransome Y, Galea S, Pabayo R, Kawachi I, Braunstein S, Nash D. Social capital is associated with late HIV diagnosis: an ecological analysis. J Acquir Immune Defic Syndr. 2016;73(2):213–21.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Frumence G, Killewo J, Kwesigabo G, Nyström L, Eriksson M, Emmelin M. Social capital and the decline in HIV transmission—a case study in three villages in the Kagera region of Tanzania. SAHARA-J J Soc Asp HIVAIDS [Internet]. 2010 [cited 2021 Apr 29], 7(3). Available from: https://www.ajol.info/index.php/saharaj/article/view/67732

  61. Phillips JC, Webel A, Rose CD, Corless IB, Sullivan KM, Voss J, et al. Associations between the legal context of HIV, perceived social capital, and HIV antiretroviral adherence in North America. BMC Public Health. 2013;8(13):736.

    Article  Google Scholar 

  62. Mukoswa GM, Charalambous S, Nelson G. The association between social capital and HIV treatment outcomes in South Africa. PLOS ONE. 2017;12(11):e0184140.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Fonner VA, Kerrigan D, Mnisi Z, Ketende S, Kennedy CE, Baral S. Social cohesion, social participation, and HIV related risk among female sex workers in Swaziland. PLOS ONE. 2014;9(1):e87527.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Saggurti N, Mishra RM, Proddutoor L, Tucker S, Kovvali D, Parimi P, et al. Community collectivization and its association with consistent condom use and STI treatment-seeking behaviors among female sex workers and high-risk men who have sex with men/transgenders in Andhra Pradesh. India AIDS Care. 2013;25(sup1):S55-66.

    Article  PubMed  Google Scholar 

  65. Shelley G, Williams W, Uhl G, Hoyte T, Eke A, Wright C, et al. An evaluation of Mpowerment on individual-level HIV risk behavior, testing, and psychosocial factors among young MSM of color: the monitoring and evaluation of MP (MEM) project. AIDS Educ Prev. 2017;29(1):24–37.

    Article  PubMed  Google Scholar 

  66. Kerrigan DL, Fonner VA, Stromdahl S, Kennedy CE. Community empowerment among female sex workers is an effective HIV prevention intervention: a systematic review of the peer-reviewed evidence from low- and middle-income countries. AIDS Behav. 2013;17(6):1926–40.

    Article  PubMed  Google Scholar 

  67. Ransome Y, Zarwell M, Robinson WT. Participation in community groups increases the likelihood of PrEP awareness: New Orleans NHBS-MSM Cycle, 2014. PLOS ONE. 2019;14(3):e0213022.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  68. Garcia J, Parker C, Parker RG, Wilson PA, Philbin M, Hirsch JS. Psychosocial implications of family and religious homophobia: insights for HIV combination prevention among black men who have sex with men. Health Educ Behav Off Publ Soc Public Health Educ. 2016;43(2):217–25.

    Google Scholar 

  69. Kimani M, van der Elst EM, Chiro O, Oduor C, Wahome E, Kazungu W, et al. PrEP interest and HIV‐1 incidence among MSM and transgender women in coastal Kenya. J Int AIDS Soc [Internet]. 2019 Jun 13 [cited 2021 Jan 20], 22(6). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6563853/

  70. Pillay D, Stankevitz K, Lanham M, Ridgeway K, Murire M, Briedenhann E, et al. Factors influencing uptake, continuation, and discontinuation of oral PrEP among clients at sex worker and MSM facilities in South Africa. PLOS ONE. 2020;15(4):e0228620.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  71. Goodreau SM, Carnegie NB, Vittinghoff E, Lama JR, Sanchez J, Grinsztejn B, et al. What drives the US and Peruvian HIV epidemics in men who have sex with men (MSM)? PloS One. 2012;7(11):e50522.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  72. Sullivan PS, Salazar L, Buchbinder S, Sanchez TH. Estimating the proportion of HIV transmissions from main sex partners among men who have sex with men in five US cities. AIDS Lond Engl. 2009;23(9):1153–62.

    Article  Google Scholar 

  73. Zhang L, Chow EPF, Wilson DP. Distributions and trends in sexual behaviors and HIV incidence among men who have sex with men in China. BMC Public Health. 2012;12(1):546.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Lachowsky NJ, Dewey CE, Dickson NP, Saxton PJW, Hughes AJ, Milhausen RR, et al. Habitual condom use across partner type and sexual position among younger gay and bisexual men: findings from New Zealand HIV behavioural surveillance 2006–2011. Sex Transm Infect. 2015;91(6):445–50.

    Article  CAS  PubMed  Google Scholar 

  75. Cai Y, Lau JTF. Multi-dimensional factors associated with unprotected anal intercourse with regular partners among Chinese men who have sex with men in Hong Kong: a respondent-driven sampling survey. BMC Infect Dis. 2014;14(1):205.

    Article  PubMed  PubMed Central  Google Scholar 

  76. Feinstein BA, Dellucci TV, Sullivan PS, Mustanski B. Characterizing sexual agreements with one’s most recent sexual partner among young men who have sex with men. AIDS Educ Prev Off Publ Int Soc AIDS Educ. 2018;30(4):335–49.

    Article  Google Scholar 

  77. Mustanski B, Newcomb ME, Clerkin EM. Relationship characteristics and sexual risk-taking in young men who have sex with men. Health Psychol Off J Div Health Psychol Am Psychol Assoc. 2011;30(5):597–605.

    Google Scholar 

  78. Newcomb ME, Ryan DT, Garofalo R, Mustanski B. The effects of sexual partnership and relationship characteristics on three sexual risk variables in young men who have sex with men. Arch Sex Behav. 2014;43(1):61–72.

    Article  PubMed  PubMed Central  Google Scholar 

  79. Greene GJ, Andrews R, Kuper L, Mustanski B. Intimacy, monogamy, and condom problems drive unprotected sex among young men in serious relationships with other men: a mixed methods dyadic study. Arch Sex Behav. 2014;43(1):73–87.

    Article  PubMed  PubMed Central  Google Scholar 

  80. Hanum N, Cambiano V, Sewell J, Phillips AN, Rodger AJ, Speakman A, et al. Use of HIV pre-exposure prophylaxis among men who have sex with men in England: data from the AURAH2 prospective study. Lancet Public Health. 2020;5(9):e501–11.

    Article  PubMed  PubMed Central  Google Scholar 

  81. Hammoud MA, Vaccher S, Jin F, Bourne A, Maher L, Holt M, et al. HIV pre-exposure prophylaxis (PrEP) uptake among gay and bisexual men in Australia and factors associated with the nonuse of PrEP among eligible men: results from a prospective cohort study. J Acquir Immune Defic Syndr. 2019;81(3):e73-84.

    Article  PubMed  Google Scholar 

  82. Gafos M, Horne R, Nutland W, Bell G, Rae C, Wayal S, et al. The context of sexual risk behaviour among men who have sex with Men seeking PrEP, and the impact of PrEP on sexual behaviour. AIDS Behav. 2019;23(7):1708–20.

    Article  PubMed  Google Scholar 

  83. Wahome EW, Graham SM, Thion’go AN, Mohamed K, Oduor T, Gichuru E, et al. PrEP uptake and adherence in relation to HIV-1 incidence among Kenyan men who have sex with men. EClinicalMedicine. 2020;26:100541.

    Article  PubMed  PubMed Central  Google Scholar 

  84. Wahome E, Graham S, Thiong’o A, Chirro O, Mohamed K, Gichuru E, et al. Assessment of PrEP eligibility and uptake among at-risk MSM participating in a HIV-1 vaccine feasibility cohort in coastal Kenya. Wellcome Open Res. 2019;4:138.

    Article  PubMed  Google Scholar 

  85. Noret M, Balavoine S, Pintado C, Siguier M, Brun A, Bauer R, et al. Daily or on-demand oral tenofovir disoproxil fumarate/emtricitabine for HIV pre-exposure prophylaxis: experience from a hospital-based clinic in France. AIDS. 2018;32(15):2161–9.

    Article  CAS  PubMed  Google Scholar 

  86. Hoornenborg E, Coyer L, Achterbergh RCA, Matser A, van der Schim Loeff MF, Boyd A, et al. Sexual behaviour and incidence of HIV and sexually transmitted infections among men who have sex with men using daily and event-driven pre-exposure prophylaxis in AMPrEP: 2 year results from a demonstration study. Lancet HIV. 2019;6(7):e447-55.

    Article  PubMed  Google Scholar 

  87. Vuylsteke B, Reyniers T, De Baetselier I, Nöstlinger C, Crucitti T, Buyze J, et al. Daily and event-driven pre-exposure prophylaxis for men who have sex with men in Belgium: results of a prospective cohort measuring adherence, sexual behaviour and STI incidence. J Int AIDS Soc. 2019;22(10):e25407.

    Article  PubMed  PubMed Central  Google Scholar 

  88. Eubanks A, Dembélé Keita B, Anoma C, Dah TTE, Mensah E, Maradan G, et al. Reaching a different population of MSM in West Africa with the integration of PrEP into a comprehensive prevention package (CohMSM-PrEP ANRS 12369-expertise France). J Acquir Immune Defic Syndr. 2020;85(3):292–301.

    Article  PubMed  Google Scholar 

  89. Amico KR, Mehrotra M, Avelino-Silva VI, McMahan V, For the iPrEx Study Team, Veloso VG, et al. Self-reported Recent PrEP dosing and drug detection in an open label PrEP study. AIDS Behav. 2016;20(7):1535–40.

    Article  PubMed  PubMed Central  Google Scholar 

  90. Marins LMS, Torres TS, da LeiteI C, Moreira RI, Luz PM, Hoagland B, et al. Performance of HIV pre-exposure prophylaxis indirect adherence measures among men who have sex with men and transgender women: results from the PrEP Brasil study. PLOS ONE. 2019;14(8):e0221281.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  91. Blumenthal J, Pasipanodya EC, Jain S, Sun S, Ellorin E, Morris S, et al. Comparing self-report pre-exposure prophylaxis adherence questions to pharmacologic measures of recent and cumulative pre-exposure prophylaxis exposure. Front Pharmacol. 2019;5(10):721.

    Article  Google Scholar 

  92. Haberer JE. Current concepts for PrEP adherence in the PrEP revolution: from clinical trials to routine practice. Curr Opin HIV AIDS. 2016;11(1):10–7.

    Article  PubMed  PubMed Central  Google Scholar 

  93. Sagaon-Teyssier L, Suzan-Monti M, Demoulin B, Capitant C, Lorente N, Préau M, et al. Uptake of PrEP and condom and sexual risk behavior among MSM during the ANRS IPERGAY trial. AIDS Care. 2016;28(sup1):48–55.

    Article  PubMed  PubMed Central  Google Scholar 

  94. Sagaon-Teyssier L, Mabire X, Laguette V, Fressard L, Suzan-Monti M, Rojas Castro D, et al. A group-based trajectory model for changes in pre-exposure prophylaxis and condom use among men who have sex with men participating in the ANRS IPERGAY trial. AIDS Patient Care STDs. 2018;32(12):495–510.

    Article  Google Scholar 

  95. Kippax S, Noble J, Prestage G, Crawford JM, Campbell D, Baxter D, et al. Sexual negotiation in the AIDS era: negotiated safety revisited. AIDS. 1997;11(2):191–7.

    Article  CAS  PubMed  Google Scholar 

  96. Kippax S, Crawford J, Davis M, Rodden P, Dowsett G. Sustaining safe sex: a longitudinal study of a sample of homosexual men. AIDS. 1993;7(2):257–64.

    Article  CAS  PubMed  Google Scholar 

  97. Elford J, Bolding G, Maguire M, Sherr L. Sexual risk behaviour among gay men in a relationship. AIDS. 1999;13(11):1407–11.

    Article  CAS  PubMed  Google Scholar 

  98. Davidovich U, de Wit JBF, Stroebe W. Assessing sexual risk behaviour of young gay men in primary relationships: the incorporation of negotiated safety and negotiated safety compliance. AIDS. 2000;14(6):701–6.

    Article  CAS  PubMed  Google Scholar 

  99. Crawford JM, Rodden P, Kippax S. Negotiated safety and other agreements between men in relationships: risk practice redefined. Int J STD AIDS. 2001;12(3):164–70.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

Our sincerest thanks to the MSM participants and the staff of the community-based organizations (ARCAD Santé PLUS, Espace Confiance, Association African Solidarité, Espoir Vie Togo) who participated in the CohMSM-PrEP study. Our thanks also to Jude Sweeney (Milan, Italy) for copyediting the article.

Funding

This study was supported by the ANRS (France Recherche Nord & Sud Sida-hiv Hépatites; ANRS 12369) and Expertise France (L’Initiative). August Eubanks and Ter Tiero Elias Dah were the recipients of doctoral fellowships from ANRS (ANRS 12369-B105) and Sidaction (2021–2-FJC-13012) for AE and from ANRS (ANRS 471 12324-B99) for TTED.

Author information

Authors and Affiliations

  1. Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de L’Information Médicale, ISSPAM, Marseille, France

    August Eubanks, Gwenaëlle Maradan, Michel Bourrelly, Marion Mora, Daniela Rojas Castro, Bruno Spire & Luis Sagaon-Teyssier

  2. ARCAD Santé PLUS, Bamako, Mali

    Bakary Coulibaly, Bintou Dembélé Keita & Luis Sagaon-Teyssier

  3. Espace Confiance, Abidjan, Côte d’Ivoire

    Camille Anoma

  4. Association African Solidarité, Ouagadougou, Burkina Faso

    Ter Tiero Elias DAH

  5. Institut National de Santé Publique, Centre Muraz, Bobo-Dioulasso, Burkina Faso

    Ter Tiero Elias DAH

  6. Espoir Vie Togo, Lomé, Togo

    Ephrem Mensah

  7. ORS PACA, Observatoire Régional de la santé Provence-Alpes-Côte d’Azur, Marseille, France

    Gwenaëlle Maradan

  8. Coalition Plus, Community-Based Research Laboratory, Pantin, France

    Michel Bourrelly, Lucas Riegel & Daniela Rojas Castro

  9. TransVIHMI, Univ Montpellier, INSERM, Montpellier, IRD, France

    Issifou Yaya & Christian Laurent

Authors
  1. August Eubanks
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bakary Coulibaly
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Bintou Dembélé Keita
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Camille Anoma
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ter Tiero Elias DAH
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ephrem Mensah
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Gwenaëlle Maradan
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Michel Bourrelly
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Marion Mora
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Lucas Riegel
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Daniela Rojas Castro
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Issifou Yaya
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Bruno Spire
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Christian Laurent
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Luis Sagaon-Teyssier
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

and the COHMSM-PrEP Study Group

Contributions

AE, BS, and LST designed the study. LST supervised the data management and statistical analysis, while BC conducted it. AE and LST co-drafted the article. AE drafted the first version of the manuscript. CL was a co-principal investigator of this study. BDK was also a co-principal investigator and coordinated the study in Mali. TTED coordinated the study in Burkina Faso. CA coordinated the study in Côte d’Ivoire. EM coordinated the study in Togo. IY contributed to the coordination of the study and oversaw data collection. IY, LST, and BC accessed and verified the data. GM, MB, MM contributed to the study’s implementation and monitoring of the social sciences component. BS coordinated the social sciences component. LR and DRC coordinated the community component. All authors reviewed and approved the manuscript.

Corresponding author

Correspondence to August Eubanks.

Ethics declarations

Conflict of Interest

The authors have no conflicts of interest to declare that are relevant to the content of this article.

Ethical Approval

This study was performed in line with the principles of the Declaration of Helsinki. The study protocol was approved by the national ethics committees of Togo (N°338/2017/MSPS/CAB/SG/DGAS/DPML/CBRS), Mali (N°2017/113/CE/FMPOS), Burkina Faso (N°2017–7-105), and Côte d’Ivoire (N°088/MSHP/CNER-kp).

Consent to Participate

Informed consent was obtained from all individual participants included in the study.

Consent for Publication

Not applicable.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 50 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Eubanks, A., Coulibaly, B., Dembélé Keita, B. et al. Rate and Predictors of Ineffective HIV Protection in African Men Who Have Sex with Men Taking Pre-Exposure Prophylaxis. AIDS Behav 26, 3524–3537 (2022). https://doi.org/10.1007/s10461-022-03692-8

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-022-03692-8

Keywords

Search

Navigation