Journal
AIDS
Volume 32, Issue 11, Pages 1527-1532Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/QAD.0000000000001874
Keywords
HIV; MSM; pre-exposure prophylaxis; risk compensation; sexual behaviour
Categories
Funding
- H-team initiative from ZonMw [522002003]
- National Institute for Public Health and the Environment
- GGD research funds
- Aidsfonds Netherlands [2013169]
- Stichting Amsterdam Dinner Foundation
- Gilead Sciences Europe Ltd [PA-HIV-PREP-16-0024]
- Gilead Sciences [CO-NL-276-4222, CO-US-276-1712]
- Janssen Pharmaceuticals [PHNL/JAN/0714/0005b/1912fde]
- M.A.C. AIDS Fund
- ViiV Healthcare [3000268822, 3000747780]
- institute of Elske Hoornenborg
- Janssen-Cilag
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Objective: HIV pre-exposure prophylaxis (PrEP) use may lead to higher STI incidence via behavioural risk compensation. We examined changes in sexual behaviour between baseline and 6 months after PrEP initiation among MSM and transgender women (TGW). Design: Prospective, open-label demonstration study at a large sexually transmitted infection (STI) clinic in Amsterdam, the Netherlands. Methods: Participants answered questions about sexual behaviour in the preceding 3 months, including number of anal sex partners and frequency of anal sex with and without condom by partner type and were tested for STI. Sexual behaviour at baseline was compared with 6 months after PrEP initiation using Wilcoxon signed rank tests. Logistic regression was used to identify factors associated with an increase in receptive condomless anal sex acts (rCASa) with casual partners. Results: Data were available for 328 (99%) MSM and 2 (1%) TGW. The number of receptive and insertive condomless anal sex acts (CASa) increased (baseline: median 11, interquartile range 4-23; 6 months: median 14, interquartile range 6-26, P<0.001), whereas the number of anal sex partners (P = 0.2) and anal sex acts (P = 0.8) remained unchanged. Prevalence of STI was stable. Older age, prior engagement in chemsex, recent use of postexposure prophylaxis and choosing a daily PrEP regimen at baseline were associated with an increase in rCASa with casual partners. Conclusion: Over the first 6 months after initiation of PrEP, an increase in insertive and receptive CASa with casual partners was observed. Long-term follow-up data are needed and STI incidence needs to be closely monitored. Copyright (C) 2018 Wolters Kluwer Health, Inc. All rights reserved.
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