دورية أكاديمية

Predictive factors for HIV infection among men who have sex with men and who are seeking PrEP: a secondary analysis of the PROUD trial

التفاصيل البيبلوغرافية
العنوان: Predictive factors for HIV infection among men who have sex with men and who are seeking PrEP: a secondary analysis of the PROUD trial
المؤلفون: White, Ellen, Dunn, David T, Desai, Monica, Gafos, Mitzy, Kirwan, Peter, Sullivan, Ann K, Clarke, Amanda, McCormack, Sheena, PROUD study group, Dolling, David I, McOwan, Alan, Gilson, Richard, Fisher, Martin, Schembri, Gabriel, Mackie, Nicola, Reeves, Iain, Portman, Mags, Saunders, John, Fox, Julie, Bayley, Jake, Brady, Michael, Bowman, Christine, Lacey, Charles J, Taylor, Stephen, White, David, Antonucci, Simone, Gill, Owen N, Nardone, Anthony, Apea, Vanessa, Clark, Drew, Davis, Paul, Hand, James, Hunt, Machel, Neale, Rebecca, O’Connell, Jackie, Portman, Margaret, Sarner, Liat, Terry, Louise, Twumasi, Angelina, Tsui, Salina, Vijeratnam, Dayan, Whyte, Ryan, Williams, Andy, Gately, Sian, Gilleran, Gerry, Lyons, Jill, McCormack, Chris, Moore, Katy, Stretton, Cathy, Acheampong, Alex, Bramley, Michael, Campbell, Marion, Chowdhry, Ruby, Eastwood, Stewart, Fennell, Babs, Hadley, Wendy, Hobbs, Kerry, Kirk, Sarah, Perry, Nicky, Rawlinson, Charlotte, Richardson, Celia, Richardson, Claire, Roche, Mark, Simpkin, Emma, Shaw, Simon, Souto, Elisa, Williams, Julia, Youssef, Elaney, Barber, Tristan, Eliot, Cindy, Fedele, Serge, Higgs, Chris, McCormick, Kathryn, Meijer, Alexandra, Pepper, Sam, Rowlands, Jane, Singh, Gurmit, SolerCarracedo, Alfredo, Sonecha, Sonali, Sullivan, Ann, Taylor, David, Thomas, Lervina, Attakora, Frederick, Bourke, Marina, Castles, Richard, Clark, Rebecca, De-Masi, Anke, Espa, Veronica, Hungwe, Rumbidzai, Lincoln, Martin, Mguni, Sifiso, Nevin-Dolan, Rhianon, Alexander, Hannah, Campbell, Lucy, Candfield, Sophie, Doshi, Shema, Liddle, Olivia, Mulka, Larissa, Saigal, Priyanka, Stevenson, James, Boateng, James, Chappell, Brynn, Currie, Susanna, Davies, Carolyn, Lebari, Dornubari, Phillips, Matthew, Southon, Lisa, Thorpe, Sarah, Vas, Anna, Ward, Chris, Warren, Claire, Yau, Stephanie, Arenas-Pinto, Alejandro, Ashraf, Asma, Bolton, Matthew, Haddow, Lewis, McNamara, Sara, Milinkovic, Ana, Minton, June, Morris, Dianne, Oakland, Clare, O’Farrell, Steve, Pellegrino, Pierre, Pett, Sarah, Vora, Nina, Young, Carmel, Zarko-Flynn, Taris, Ayap, Wilbert, Chen, Ling Jun, Croucher, Adam, Fidler, Sarah, Kuldanek, Kristin, Legg, Ken, Leon, Agathe, Naous, Nadia, Quinn, Killian, Rey, Severine, Zhou, Judith, Bevan, Margaret-Anne, Francia, Nina, Hamlyn, Eleanor, Hurley, Lisa, Iveson, Helen, Jendrulek, Isabelle, Murray, Tammy, Sharp, Alice, Skingsley, Andrew, Tam, Chi Kai, Al Teague, Caroline Thomas, Tiraboschi, Juan-Manuel, Brewer, Christine, Evans, Richard, Gravely, Jan, Lacey, Charles, Lamont, Gary, Martin, Fabiola, Morris, Georgina, Russell-Sharpe, Sarah, Wightman, John, Bains, Anthony, Bell, Gill, Cox, Terry, Dewsnap, Claire, Hughes, Charlie, Loftus, Hannah, Sutton, Naomi, Talbot, Debbie, Tucker, Vince, Banbury, Sarah, Brodnicki, Elizabeth, Chung, Christina, Fairbrother, Keith, Gabriel, Michelle, Khan, Sajad, Khan, Shabana, Mauger, Brendan, Sancha, Gemma, South, Annabelle, Sowunmi, Yinka, Spencer, Susan, Rae, Caroline, Rayment, Michael, Nutland, Will, Wayal, Sonali, Desai, Sarika, Field, Nigel, Gill, Noel, Hyland, Kate, Seyan, Parnam, Clarke, Rich, Rooney, Jim
بيانات النشر: BMJ Publishing Group Ltd
سنة النشر: 2019
المجموعة: HighWire Press (Stanford University)
مصطلحات موضوعية: Epidemiology
الوصف: Objectives Pre-exposure prophylaxis (PrEP) is a highly effective method of HIV prevention for men who have sex with men (MSM). However, uncertainty remains around the optimal eligibility criteria for PrEP, specifically whether there are subgroups at low risk of HIV for whom PrEP might not be warranted. Methods PROUD was an open-label waitlist trial design that randomised MSM attending participating sexual health centres in England to receive PrEP immediately (IMM) or after a deferral period of 1 year (DEF). This analysis is based on participants who were randomised to the deferred arm, when they did not have access to PrEP. HIV incidence was compared between subgroups defined by baseline characteristics. Results Overall, 21 participants acquired HIV infection over 239.3 person-years (PY) follow-up, yielding an incidence rate of 8.8/100 PY (95% CI 5.4 to 13.4). Two highly significant predictors for HIV acquisition were identified. Men with a self-reported diagnosis of syphilis, rectal chlamydia (CT) or rectal gonorrhoea (GC) in the previous 12 months had an incidence of 17.2/100 PY (95% CI 9.7 to 28.5); those reporting receptive anal intercourse without a condom (ncRAI) with two or more partners in the previous 3 months had an incidence of 13.6/100 PY (95% CI 7.9 to 21.7). The incidence rate among participants lacking both of these risk factors was 1.1/100 PY (1/87.6, 95% CI 0.03 to 6.4). Conclusions The high HIV incidence in PROUD suggests that most participants appropriately judged their need for PrEP. Eligibility criteria for a PrEP programme can therefore be broad, as in the current guidelines. However, a recent history of syphilis or rectal CT/GC, or multiple ncRAI partners indicates a high imminent risk of HIV infection. MSM with any of these characteristics should be offered PrEP as a matter of urgency.
نوع الوثيقة: text
وصف الملف: text/html
اللغة: English
العلاقة: http://sti.bmj.com/cgi/content/short/95/6/449Test; http://dx.doi.org/10.1136/sextrans-2018-053808Test
DOI: 10.1136/sextrans-2018-053808
الإتاحة: https://doi.org/10.1136/sextrans-2018-053808Test
http://sti.bmj.com/cgi/content/short/95/6/449Test
حقوق: Copyright (C) 2019, The Medical Society for the Study of Venereal Disease
رقم الانضمام: edsbas.5F27A71D
قاعدة البيانات: BASE