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Recent HIV Risk Behavior and Partnership Type Predict HIV Pre-Exposure Prophylaxis Adherence in Men Who Have Sex with

Jill Blumenthal1, David J Moore1, Sonia Jain1

  • 11 Department of Medicine, University of California San Diego, La Jolla, California.

AIDS Patient Care and Stds
|May 9, 2019
PubMed

Insights

Men who have sex with men (MSM) with higher HIV risk behaviors show better adherence to pre-exposure prophylaxis (PrEP). Riskier behaviors and partnerships correlate with higher PrEP drug levels, indicating sustained motivation and adherence.

Area of Science:

  • Clinical Medicine
  • Infectious Diseases
  • Public Health

Background:

  • Pre-exposure prophylaxis (PrEP) is a key HIV prevention strategy for men who have sex with men (MSM).
  • Understanding factors influencing long-term PrEP adherence, such as risk behavior and partnership dynamics, is crucial for optimizing HIV prevention efforts.

Purpose of the Study:

  • To investigate the impact of recent HIV risk behavior and partnership type on long-term pre-exposure prophylaxis (PrEP) adherence among HIV-negative MSM and transgender women.
  • To analyze changes in HIV risk category and partnership type over 48 weeks and their association with PrEP adherence.

Main Methods:

  • A 48-week randomized study (TAPIR) included HIV-negative MSM and transgender women.
  • HIV risk was assessed using the modified Calculated Risk (mCalcR) Score, and partnership type was categorized.
  • PrEP adherence was measured by intracellular tenofovir-diphosphate (TFV-DP) levels.

Main Results:

  • HIV risk category remained stable, while partnership type shifted towards lower-risk categories (e.g., fewer partners).
  • Participants with moderate and high/very high risk behaviors demonstrated higher TFV-DP levels compared to the low-risk group.
  • Individuals in lower-risk partnerships (no/single partner) had lower TFV-DP levels than those with single HIV-positive or multiple partners.

Conclusions:

  • Despite a shift towards lower-risk partnerships, HIV risk behavior remained stable.
  • Higher PrEP drug levels were observed in individuals with riskier behaviors and partnerships, suggesting sustained motivation and adherence.
  • These findings highlight the complex interplay between risk behavior, partnership dynamics, and long-term PrEP adherence in MSM and transgender women.
Keywords:
HIV preventionHIV riskmedication adherencemen who have sex with men (MSM)partnershipspre-exposure prophylaxis (PrEP)

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