High pre-exposure prophylaxis uptake and early adherence among men who have sex with men and transgender women at risk for HIV Infection: the PrEP Brasil demonstration project

Detalhes bibliográficos
Autor(a) principal: Hoagland, Brenda Regina de Siqueira
Data de Publicação: 2017
Outros Autores: Moreira, Ronaldo I, De Boni, Raquel Brandini, Kallas, Esper Georges, Madruga, José Valdez Ramalho, Vasconcelos, Ricardo, Goulart, Silvia, Torres, Thiago Silva, Marins, Luana Monteiro Spíndola, Anderson, Peter L, Luz, Paula Mendes, Leite, Iuri da Costa, Liu, Albert Y, Santos, Valdiléa Gonçalves Veloso dos, Grinsztejn, Beatriz
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/25811
Resumo: Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
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spelling Hoagland, Brenda Regina de SiqueiraMoreira, Ronaldo IDe Boni, Raquel BrandiniKallas, Esper GeorgesMadruga, José Valdez RamalhoVasconcelos, RicardoGoulart, SilviaTorres, Thiago SilvaMarins, Luana Monteiro SpíndolaAnderson, Peter LLuz, Paula MendesLeite, Iuri da CostaLiu, Albert YSantos, Valdiléa Gonçalves Veloso dosGrinsztejn, Beatriz2018-04-12T14:49:49Z2018-04-12T14:49:49Z2017HOAGLAND, Brenda Regina de Siqueira et al. High pre-exposure prophylaxis uptake and early adherence among men who have sex with men and transgender women at risk for HIV Infection: the PrEP Brasil demonstration project. Journal of the International AIDS Society, v. 20, n.1, 2017.0894-9255https://www.arca.fiocruz.br/handle/icict/2581110.7448/IAS.20.1.21472engBioMed CentralHigh pre-exposure prophylaxis uptake and early adherence among men who have sex with men and transgender women at risk for HIV Infection: the PrEP Brasil demonstration projectinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleFundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Universidade de São Paulo. School of Medicine. São Paulo, SP, Brazil.Universidade de São Paulo. School of Medicine. São Paulo, SP, Brazil.Universidade de São Paulo. School of Medicine. São Paulo, SP, Brazil.Universidade de São Paulo. School of Medicine. São Paulo, SP, Brazil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Skaggs School of Pharmacy and Pharmaceutical Sciences. University of Colorado. Denver, Aurora, CO, USA.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.San Francisco Department of Public Health. Bridge HIV. San Francisco, CA, USA.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Introduction: The efficacy of pre-exposure prophylaxis (PrEP) in preventing sexual acquisition of human immunodeficiency virus (HIV) is well established. Little is known about the feasibility of PrEP implementation in middle-income settings with concentrated epidemics among men who have sex with men (MSM) and transgender women (TGW). Methods: PrEP Brasil is a prospective, multicentre, open-label demonstration project assessing PrEP delivery in the context of the Brazilian Public Health System. HIV-uninfected MSM and TGW in 3 referral centres in Rio de Janeiro and São Paulo were evaluated for eligibility and offered 48 weeks of daily emtricitabine/tenofovir for PrEP. Concentrations of tenofovir diphosphate in dried blood spot samples (DBS) at week 4 after enrolment (early adherence) were measured. Predictors of drug levels were assessed using ordinal logistic regression models considering the DBS drug level as a 3 level variable (<350 fmol/ punch, ≥350–699 fmol/punch and ≥700 fmol/punch). Results: 1,270 individuals were assessed for participation; n = 738 were potentially eligible and n = 450 were offered PrEP (PrEP uptake was 60.9%). Eligible but not enrolled individuals were younger, had lower HIV risk perception and had lower PrEP awareness. At week 4, 424 participants (of the 450 enrolled) had DBS TFV-DP concentrations, 94.1% in the protective range (≥350 fmol/punch, consistent with ≥2 pills per week), and 78% were in the highly protective range (≥700 fmol/punch, ≥4 pills per week). Participants with ≥12 years of schooling had 1.9 times the odds (95%CI 1.10–3.29) of a higher versus lower drug level than participants with <12 years of schooling. Condomless receptive anal intercourse in the prior 3 months was also associated with higher drug levels (adjusted OR = 1.78; 95% CI 1.08–2.94). Conclusions: The high uptake and early adherence indicate that PrEP for high-risk MSM and TGW can be successfully delivered in the context of the Brazilian Public Health System. Interventions to address disparities on PrEP awareness and HIV risk perception among the younger and less educated are urgently needed in order to maximize the impact of this prevention strategy on the reduction of HIV infection among MSM and TGW in Brazil.DRUG LevelsHIVPre-Exposure ProphylaxisTransgender womenHIVProfilaxia Pré-ExposiçãoTransexualidadeMulheresinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; 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dc.title.en.fl_str_mv High pre-exposure prophylaxis uptake and early adherence among men who have sex with men and transgender women at risk for HIV Infection: the PrEP Brasil demonstration project
title High pre-exposure prophylaxis uptake and early adherence among men who have sex with men and transgender women at risk for HIV Infection: the PrEP Brasil demonstration project
spellingShingle High pre-exposure prophylaxis uptake and early adherence among men who have sex with men and transgender women at risk for HIV Infection: the PrEP Brasil demonstration project
Hoagland, Brenda Regina de Siqueira
DRUG Levels
HIV
Pre-Exposure Prophylaxis
Transgender women
HIV
Profilaxia Pré-Exposição
Transexualidade
Mulheres
title_short High pre-exposure prophylaxis uptake and early adherence among men who have sex with men and transgender women at risk for HIV Infection: the PrEP Brasil demonstration project
title_full High pre-exposure prophylaxis uptake and early adherence among men who have sex with men and transgender women at risk for HIV Infection: the PrEP Brasil demonstration project
title_fullStr High pre-exposure prophylaxis uptake and early adherence among men who have sex with men and transgender women at risk for HIV Infection: the PrEP Brasil demonstration project
title_full_unstemmed High pre-exposure prophylaxis uptake and early adherence among men who have sex with men and transgender women at risk for HIV Infection: the PrEP Brasil demonstration project
title_sort High pre-exposure prophylaxis uptake and early adherence among men who have sex with men and transgender women at risk for HIV Infection: the PrEP Brasil demonstration project
author Hoagland, Brenda Regina de Siqueira
author_facet Hoagland, Brenda Regina de Siqueira
Moreira, Ronaldo I
De Boni, Raquel Brandini
Kallas, Esper Georges
Madruga, José Valdez Ramalho
Vasconcelos, Ricardo
Goulart, Silvia
Torres, Thiago Silva
Marins, Luana Monteiro Spíndola
Anderson, Peter L
Luz, Paula Mendes
Leite, Iuri da Costa
Liu, Albert Y
Santos, Valdiléa Gonçalves Veloso dos
Grinsztejn, Beatriz
author_role author
author2 Moreira, Ronaldo I
De Boni, Raquel Brandini
Kallas, Esper Georges
Madruga, José Valdez Ramalho
Vasconcelos, Ricardo
Goulart, Silvia
Torres, Thiago Silva
Marins, Luana Monteiro Spíndola
Anderson, Peter L
Luz, Paula Mendes
Leite, Iuri da Costa
Liu, Albert Y
Santos, Valdiléa Gonçalves Veloso dos
Grinsztejn, Beatriz
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Hoagland, Brenda Regina de Siqueira
Moreira, Ronaldo I
De Boni, Raquel Brandini
Kallas, Esper Georges
Madruga, José Valdez Ramalho
Vasconcelos, Ricardo
Goulart, Silvia
Torres, Thiago Silva
Marins, Luana Monteiro Spíndola
Anderson, Peter L
Luz, Paula Mendes
Leite, Iuri da Costa
Liu, Albert Y
Santos, Valdiléa Gonçalves Veloso dos
Grinsztejn, Beatriz
dc.subject.en.en.fl_str_mv DRUG Levels
HIV
Pre-Exposure Prophylaxis
Transgender women
topic DRUG Levels
HIV
Pre-Exposure Prophylaxis
Transgender women
HIV
Profilaxia Pré-Exposição
Transexualidade
Mulheres
dc.subject.decs.pt_BR.fl_str_mv HIV
Profilaxia Pré-Exposição
Transexualidade
Mulheres
description Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
publishDate 2017
dc.date.issued.fl_str_mv 2017
dc.date.accessioned.fl_str_mv 2018-04-12T14:49:49Z
dc.date.available.fl_str_mv 2018-04-12T14:49:49Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv HOAGLAND, Brenda Regina de Siqueira et al. High pre-exposure prophylaxis uptake and early adherence among men who have sex with men and transgender women at risk for HIV Infection: the PrEP Brasil demonstration project. Journal of the International AIDS Society, v. 20, n.1, 2017.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/25811
dc.identifier.issn.pt_BR.fl_str_mv 0894-9255
dc.identifier.doi.none.fl_str_mv 10.7448/IAS.20.1.21472
identifier_str_mv HOAGLAND, Brenda Regina de Siqueira et al. High pre-exposure prophylaxis uptake and early adherence among men who have sex with men and transgender women at risk for HIV Infection: the PrEP Brasil demonstration project. Journal of the International AIDS Society, v. 20, n.1, 2017.
0894-9255
10.7448/IAS.20.1.21472
url https://www.arca.fiocruz.br/handle/icict/25811
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv BioMed Central
publisher.none.fl_str_mv BioMed Central
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
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collection Repositório Institucional da FIOCRUZ (ARCA)
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