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Feasibility of Short-Term PrEP Uptake for Men Who Have Sex With Men With Episodic Periods of Increased HIV Risk

James E Egan1,2, Ken Ho3, Ron Stall1,2

  • 1Department of Behavioral and Community Health Sciences, Graduate School for Public Health, University of Pittsburgh, Pittsburgh, PA.

Journal of Acquired Immune Deficiency Syndromes (1999)
|July 22, 2020
PubMed
Abstract

Insights

Episodic pre-exposure prophylaxis (PrEP) is a feasible HIV prevention strategy for men who have sex with men (MSM) during high-risk periods like vacations. High adherence and tolerability suggest potential for transitioning to long-term PrEP use.

Area of Science:

  • Public Health
  • Infectious Disease Prevention
  • Pharmacology

Background:

  • Pre-exposure prophylaxis (PrEP) using emtricitabine/tenofovir disoproxil fumarate is effective in preventing HIV acquisition.
  • Daily PrEP may not be suitable for all gay, bisexual, and other men who have sex with men (MSM) due to episodic risk, cost, or concerns about long-term medication use.

Purpose of the Study:

  • To evaluate the feasibility of short-term, fixed-interval episodic PrEP (Epi-PrEP) for vacationing MSM.
  • To assess adherence and tolerability of Epi-PrEP in a pilot clinic-based program.

Main Methods:

  • A nonrandomized, observational clinical intervention study.
  • Assessed adherence via self-report and plasma tenofovir levels in 48 MSM over 3 months.
  • Focused on participants anticipating defined high-risk periods, such as vacations.

Main Results:

  • High adherence (93.7% with tenofovir levels consistent with daily use) was observed.
  • Nearly 75% reported condomless sex during vacation; about 33% reported recreational drug use.
  • Epi-PrEP was well tolerated, with no serious adverse events. One HIV infection occurred due to post-study PrEP access lapse.

Conclusions:

  • Episodic PrEP (Epi-PrEP) is well-tolerated and demonstrates high adherence among at-risk MSM.
  • Initiating PrEP during vacation may serve as a bridge to long-term daily PrEP use for some individuals.
  • Epi-PrEP offers a viable alternative for HIV prevention in specific, high-risk scenarios.

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