1Socios En Salud Sucursal Peru, Peru, 2International Rectal. Microbicide Advocates - América Latina y el Caribe, Peru,. 3University of California, Los Angeles, ...
TUESDAY, 18 OCTOBER Poster Discussion 04: Prepping for PrEP
PD04.03LB
PD04.04LB
ABSTRACT WITHDRAWN
“PrEP in the Wild” - Preliminary Results from a Global Survey on “Informal” PrEP Use in Settings Where It Is Approved and Where It Is Not Jerome Galea1, Ryan Cook3, Jim Pickett4, Pamina Gorbach3 Socios En Salud Sucursal Peru, Peru, 2International Rectal Microbicide Advocates - América Latina y el Caribe, Peru, 3 University of California, Los Angeles, Fielding School of Public Health & Division of Infectious Diseases, United States, 4AIDS Foundation of Chicago, United States, 5International Rectal Microbicide Advocates, United States Background: Antiretrovirals (ARVs) for preexposure prophylaxis of HIV (PrEP) are used “informally” in settings where it has been approved and where it has not, but user characteristics and practices are largely unknown. Methods: During February-July, 2016, an internet survey of informal PrEP use was deployed globally in English, French and Spanish. An interim analysis of users and the frequency of their practices was conducted. Results: 314 surveys were completed including 52 from respondents who tried but failed to access PrEP. Users were from 29 countries with ages ranging from 19-71 years (median 39); 97% were male; 93% were gay; 100% had sex with men; and, 24% had an HIV-positive primary partner. Chief reasons for PrEP use were: to “let go” during sex (80%); sex with HIV negative/unknown persons (76%); prefer condomless sex (71%); fear of HIV (67%); backup to condoms (48%); sex with HIVpositive person (47%). 27% used PrEP with no medical care, acquiring ARVs via the internet (56%); others (32%); or unused post-exposure prophylaxis pills (20%). Users with medical care received tests for: HIV (96%); STI (92%); hepatitis B (71%); creatinine levels (75%); bone mineral density (25%), and 86% were told to test for HIV quarterly. Among all users, ARVs used included: Truvada (67%); generic Truvada (53%); Atripla (5%); and, Tenofovir (2%). 70% reported daily ARV use, 69% reported uninterrupted use and 16% reported sharing ARVs with others. Barriers to PrEP access were: cost (60%); doctor refusal (50%); illegal to import ARVs into country (35%); no continuous supply (64%); side effects (31%); and, stigma (11%). Conclusions: Informal PrEP users were mainly gay men using daily Truvada under medical supervision, but nearly a third self-managed their care and ARV access. For PrEP to work, in addition to ARVs, regular medical monitoring and adherence/ sexual health counseling are required. Barriers to PrEP access, beginning with formal country approvals, require urgent attention, if implementation is to be successful.
HIV Research for Prevention 2016 | www.hivr4p.org
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POSTER DISCUSSIONS
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