Baseline variables associated with subsequent HIV seroconversion among gay, bisexual and other men who have sex with men and transgender women: a prospective, multicenter PrEP demonstration study (ImPrEP)Research in context

Baseline variables associated with subsequent HIV seroconversion among gay, bisexual and other men who have sex with men and transgender women: a prospective, multicenter PrEP demonstration study (ImPrEP)Research in context

Summary: Background: Ongoing implementation of HIV pre-exposure prophylaxis (PrEP) in Latin America should consider lessons learned from implementation projects such as ImPrEP (Brazil/Mexico/Peru, 2018–2021). In this analysis we assessed the effect of variables ascertained in early appointments on...

Full description

Saved in:
Bibliographic Details
Main Authors: Carlos F. Caceres, Heather Pines, Kelika A. Konda, Annick Borquez, Ronaldo Moreira, Iuri Leite, Pedro Amparo, Marcelo Cunha, Thiago S. Torres, Juan V. Guanira, Jean-Pierre Jirón, Brenda Hoagland, Heleen Vermandere, Marcos Benedetti, Hamid Vega, Carlos M. Benites, Cristina Pimenta, Beatriz Grinztejn, Valdiléa Veloso, J. David Urbaez-Brito, Polyana d’Albuquerque, Claudio Palombo, Paulo Ricardo Alencastro, Raquel Keiko de Luca Ito, João L. Benedetti, Fabio V. Maria, Paula M. Luz, Lucilene Freitas, Kim Geraldo, Monica Derrico, Sandro Nazer, Tania Kristic, Renato Girade, Renato Lima, Antônio R. Carvalho, Carla Rocha, Pedro Leite, Marcio Lessa, Marilia Santini-Oliveira, Daniel R.B. Bezerra, Cleo de Oliveira Souza, Jacinto Corrêa, Marcelo Alves, Carolina Souza, Camilla Portugal, Mônica dos Santos Valões, Gabriel Lima Mota, Joyce Alves Gomes, Cynthia Ferreira Lima Falcão, Fernanda Falcão Riberson, Luciano Melo, Talita Andrade Oliveira, Agnaldo Moreira Oliveira Júnior, Bruna Fonseca, Leonor Henriette Lannoy, Ludymilla Anderson Santiago Carlos, João Paulo Cunha, Sonia Maria de Alencastro Coracini, Thiago Oliveira Rodrigues, Emília Regina Scharf Mettrau, Kelly Vieira Meira, Heder Tavares, Ana Paula Nunes Viveiros Valeiras, Taiane Miyake Alves de Carvalho Rocha, Alex Amorim, Patrícia Sabadini, Luiz Gustavo Córdoba, Caio Gusmão, Erika Faustino, Julia Soares da Silva Hansen, Agatha Mirian Cunha, Neuza Uchiyama Nishimura, Jaime Eduardo Flygare Razo Prereira Santos, Aline Barnabé Cano, Willyam Magnum Telles Dias, Magô Tonhon, Tania Regina Rezende, Alex Gomes, Eloá dos Santos Rodrigues, Maria das Dores Aires Carneiro, Alexandre Castilho, Mariana Carvalho, Dulce Diaz-Sosa, Centli Guillen-Diaz-Barriga, Lorena Hernández, Rebeca Robles, Maria Elena Medina-Mora, Marcela González, Ivonne Huerta Icelo, Araczy Martinez Davalos, José Gomez Castro, Luis Obed Ocampo Valdez, Fernanda Ramírez Barajas, Verónica Ruiz González, Galileo Vargas Guadarrama, Israel Macías, Jehovani Tena Sánchez, Juan Pablo Osuna Noriega, H. Rodrigo Moheno M, Jorge M. Bernal Ramírez, Víctor Dante Galicia Juarez, Gerardo Vizcaíno, Francisco Javier Arjona, Gino Calvo, Silver Vargas, Oliver Elorreaga, Ximena Gutierrez, Fernando Olivos, Damaris Caviedes, Daniella Adriazola, Eduardo Juárez, Gabriela Mariño, Jazmin Qquellon, Francesca Vasquez, Jean Pierre Jiron, Sonia Flores, Karen Campos
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:The Lancet Regional Health. Americas
Subjects:
Pre-exposure prophylaxis
HIV seroconversion
HIV seroincidence
Sexual and gender minorities
Medication adherence
Latin America
Online Access:http://www.sciencedirect.com/science/article/pii/S2667193X25001085
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Summary: Background: Ongoing implementation of HIV pre-exposure prophylaxis (PrEP) in Latin America should consider lessons learned from implementation projects such as ImPrEP (Brazil/Mexico/Peru, 2018–2021). In this analysis we assessed the effect of variables ascertained in early appointments on HIV seroconversion among ImPrEP participants. Methods: ImPrEP enrolled HIV-negative men who have sex with men and transgender women (MSM/TGW) aged 18+ years reporting recent condomless anal sex, anal sex with HIV-positive partners, transactional sex, or sexually transmitted infections (STI). Participants received a 30-day PrEP supply; at the 30-day visit and quarterly thereafter they completed behavioural assessments, underwent HIV testing, and received 3-month PrEP supplies if HIV-negative. PrEP adherence was measured using the medication possession ratio (MPR) at the 30-day visit. We used Cox's proportional hazards regression to examine the effect of our sociodemographic, behavioural, STI, and early PrEP care engagement variables of interest on time to HIV seroconversion. Findings: Compared to participants in Brazil, the hazard ratio for HIV seroconversion was higher among those in Peru (HR = 7.91, 95% CI: 4.74–13.20). Compared to participants aged ≥35 years, the HR for HIV seroconversion was higher for those aged 18–24 (aHR = 4.84, 95% CI: 2.55–9.17 and 25–34 (aHR = 2.43, 95% CI: 1.21–4.91). HIV seroconversion was also associated with transgender identity (aHR = 2.28, 95% CI: 1.12–4.66), transactional sex (aHR = 1.88, 95% CI: 1.18–2.99), receptive condomless anal sex (aHR = 2.42, 95% CI: 1.42–4.12), STI diagnosis (aHR = 1.93, 95% CI: 1.25–2.99), and a MPR < 0.6 (aHR = 2.64, 95% CI: 1.52–4.60). Interpretation: While moderate-high, HIV incidence among ImPrEP participants represented a considerable reduction from figures observed among MSM/TGW not using PrEP/PEP. Interventions to improve PrEP adherence are needed among new Latin American PrEP users, especially if baseline factors associated with seroconversion are present. Long-acting injectable PrEP can also become useful for this population. Funding: This study was funded by UNITAID.
ISSN:2667-193X

Similar Items