Behavioral Changes Following Uptake of HIV Pre-exposure Prophylaxis Among Men Who Have Sex with Men in a Clinical Setting
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We describe changes in sexual behaviors among men who have sex with men (MSM) following initiation of pre-exposure prophylaxis (PrEP) in a clinic-based sample of MSM initiating PrEP in Providence, Rhode Island. Data were collected at baseline, 3, and 6 months following PrEP initiation including total number of anal sex partners and condom use. A longitudinal mixed effects model assessed changes in number of partners and condom use over time, adjusting for age, race, and education. There was no statistically significant difference in total number of partners over time. There was a significant increase in number of condomless anal sex partners at the 6-month visit compared to baseline (mean change +1.31 partners, 95% confidence interval 0.09–2.53, P = 0.035). As condomless anal sex may increase following PrEP uptake, adherence counseling and efforts to retain patients in PrEP care, especially during periods of non-condom use, are important as PrEP is more widely implemented.
KeywordsPre-exposure prophylaxis Men who have sex with men HIV Implementation Behavioral compensation
PAC is supported by the National Institute of Allergy and Infectious Diseases (1K23AI096923). CEO is supported by the National Institute on Drug Abuse (T32DA013911) and the National Institute of Mental Health (R25MH083620). Additional support was provided by the Lifespan/Tufts/Brown Center for AIDS Research (P30AI042853). RRP is supported by the National Center for Advancing Translational Sciences of the National Institutes of Health (Washington University Institute of Clinical and Translational Sciences UL1TR000448, sub-award KL2TR000450).
Compliance with Ethical Standards
Conflicts of interest
KHM has received unrestricted research grants from Gilead Sciences. LM reports institutional programmatic funding, consulting fees, and participation in on the speaker bureau from Gilead Sciences. CEO, ASN, MM, AA, RRP and PAC have declared no conflicts of interest.
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. Written informed consent was obtained from all individual participants included in the study.
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