Recent studies have highlighted the efficacy of and willingness to use pre-exposure prophylaxis (PrEP) to prevent HIV infection among people who inject drugs (PWID), however knowledge of real-world applicability is limited. We aimed to quantify the real-world eligibility for HIV-PrEP among HIV-negative PWID in Montreal, Canada (n = 718). Eligibility was calculated according to US Centers for Disease Control and Prevention (CDC) guidelines and compared to risk of HIV acquisition according to the assessing the risk of contracting HIV (ARCH-IDU) risk screening tool. Over one-third of participants (37%) were eligible for HIV PrEP, with 1/3 of these eligible due to sexual risk alone. Half of participants were considered high risk of HIV acquisition according to ARCH-IDU, but there was poor agreement between the two measures. Although a large proportion of PWID were eligible for HIV-PrEP, better tools that are context- and location-informed are needed to identify PWID at higher risk of HIV acquisition.
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We thank Rachel Bouchard, Élisabeth Deschênes, Marie-Eve Turcotte, Maryse Beaulieu, and the other staff working at the HEPCO research site. We also thank the study participants; without them, this research would not be possible. This work was supported by Canadian Institutes of Health Research [(CIHR), Grants MOP135260, MOP210232]; the Réseau SIDA et Maladies Infectieuses du Fonds de Recherche du Québec – Santé [(FRQ-S), Grant FRSQ5227], and the National Institutes of Health, National Institute on Drug Abuse (NIH NIDA, Grant 1R01DA045713-01). B.J. is supported through FRQ-S and CanHepC post-doctoral fellowships. S.H. is supported through a CanHepC postdoctoral fellowship. E.R. holds the chair in addiction research funded by the Charles LeMoyne Hospital Foundation, and the Faculty of Medicine and Health Sciences of Université de Sherbrooke.
Conflict of interest
Julie Bruneau received advisor fees from Gilead Sciences and Merck and a research grant from Gilead Sciences, outside of this current work. Joseph Cox has received advisory fees, honoraria, and research funds from Gilead Sciences, Merck and ViiV. The authors not named here have disclosed no conflicts of interest.
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Picard, J., Jacka, B., Høj, S. et al. Real-World Eligibility for HIV Pre-exposure Prophylaxis Among People Who Inject Drugs. AIDS Behav 24, 2400–2408 (2020). https://doi.org/10.1007/s10461-020-02800-w
- People who inject drugs
- HIV prevention
- Pre-exposure prophylaxis
- PrEP eligibility guidelines
- Men who have sex with men