Increasing event‐driven HIV pre‐exposure prophylaxis use among gay, bisexual and other men who have sex with men in Australia: results from behavioural surveillance 2019–2023
Abstract Introduction HIV pre‐exposure prophylaxis (PrEP) has been publicly available since 2018 in Australia as a daily regimen. In 2019, clinical guidelines were updated to support guidance on event‐driven PrEP (ED‐PrEP) use. We assessed trends in the PrEP dosing regimen by comparing daily PrEP us...
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Wiley
2024-11-01
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| Series: | Journal of the International AIDS Society |
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| Online Access: | https://doi.org/10.1002/jia2.26398 |
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| author | Curtis Chan Martin Holt Anthony K. J. Smith Timothy R. Broady James MacGibbon Limin Mao Ben Wilcock John Rule Benjamin R. Bavinton |
| author_facet | Curtis Chan Martin Holt Anthony K. J. Smith Timothy R. Broady James MacGibbon Limin Mao Ben Wilcock John Rule Benjamin R. Bavinton |
| author_sort | Curtis Chan |
| collection | DOAJ |
| description | Abstract Introduction HIV pre‐exposure prophylaxis (PrEP) has been publicly available since 2018 in Australia as a daily regimen. In 2019, clinical guidelines were updated to support guidance on event‐driven PrEP (ED‐PrEP) use. We assessed trends in the PrEP dosing regimen by comparing daily PrEP use to ED‐PrEP among cisgender gay, bisexual and other men who have sex with men (GBMSM). Methods Data from repeated, cross‐sectional, national behavioural surveillance surveys were analysed from 2019 to 2023 among participants not living with HIV. Logistic regression models were conducted to assess trends and compared ED‐PrEP users to non‐PrEP users and daily PrEP. Results Among 38,880 participants, overall PrEP use with any regimen increased from 27.6% in 2019 to 42.7% in 2023 (OR = 1.16, 95% CI = 1.15−1.18, p < 0.001). Among 12,922 participants who reported PrEP use in the last 6 months, the proportion reporting ED‐PrEP use increased from 7.6% in 2019 to 27.8% in 2023 (OR = 1.41, 95% CI = 1.37−1.46, p < 0.001) with those who reported daily PrEP decreasing from 92.4% to 63.3% (OR = 0.64, 95% CI = 0.62−0.66, p < 0.001). In a cross‐sectional sub‐sample in 2022–2023 (n = 8840), compared to ED‐PrEP users, non‐PrEP users were less likely to have received three or more HIV tests in the last 12 months (aRRR = 0.26, 95% CI = 0.22−0.31, p < 0.001), have 2−10 male sexual partners in the last 6 months (aRRR = 0.24, 95% CI = 0.14−0.41, p < 0.001) or 11 or more (aRRR = 0.26, 95% CI = 0.15−0.45, p < 0.001) compared to none, or to report condomless anal intercourse with casual partners (aRRR = 0.38, 95% CI = 0.32−0.46, p < 0.001). Compared to ED‐PrEP users, daily PrEP users were more likely to have received three of more HIV tests in the last year (aRRR = 3.73, 95% CI = 3.15−4.40, p < 0.001) and less likely to be born overseas and lived in Australia for less than 5 years compared to being born in Australia (aRRR = 0.64, 95% CI = 0.49−0.83, p = 0.001). Conclusions While daily PrEP remains the most common PrEP dosing regimen among GBMSM in Australia, there has been a steep increase in the proportion of PrEP users who are taking ED‐PrEP. Monitoring of PrEP use should continue to adapt to new dosing methods and future PrEP options. As ED‐PrEP use increases, further work is needed to ensure those taking ED‐PrEP are taking it effectively to prevent HIV. |
| format | Article |
| id | doaj-art-9205a4f3a7db465bb9991ea9cebcd76a |
| institution | OA Journals |
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| language | English |
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| series | Journal of the International AIDS Society |
| spelling | doaj-art-9205a4f3a7db465bb9991ea9cebcd76a2025-08-20T02:23:08ZengWileyJournal of the International AIDS Society1758-26522024-11-012711n/an/a10.1002/jia2.26398Increasing event‐driven HIV pre‐exposure prophylaxis use among gay, bisexual and other men who have sex with men in Australia: results from behavioural surveillance 2019–2023Curtis Chan0Martin Holt1Anthony K. J. Smith2Timothy R. Broady3James MacGibbon4Limin Mao5Ben Wilcock6John Rule7Benjamin R. Bavinton8Kirby Institute, UNSW Sydney Sydney New South Wales AustraliaCentre for Social Research in Health, UNSW Sydney Sydney New South Wales AustraliaCentre for Social Research in Health, UNSW Sydney Sydney New South Wales AustraliaCentre for Social Research in Health, UNSW Sydney Sydney New South Wales AustraliaCentre for Social Research in Health, UNSW Sydney Sydney New South Wales AustraliaCentre for Social Research in Health, UNSW Sydney Sydney New South Wales AustraliaHealth Equity Matters Sydney New South Wales AustraliaNational Association of People with HIV Australia Sydney New South Wales AustraliaKirby Institute, UNSW Sydney Sydney New South Wales AustraliaAbstract Introduction HIV pre‐exposure prophylaxis (PrEP) has been publicly available since 2018 in Australia as a daily regimen. In 2019, clinical guidelines were updated to support guidance on event‐driven PrEP (ED‐PrEP) use. We assessed trends in the PrEP dosing regimen by comparing daily PrEP use to ED‐PrEP among cisgender gay, bisexual and other men who have sex with men (GBMSM). Methods Data from repeated, cross‐sectional, national behavioural surveillance surveys were analysed from 2019 to 2023 among participants not living with HIV. Logistic regression models were conducted to assess trends and compared ED‐PrEP users to non‐PrEP users and daily PrEP. Results Among 38,880 participants, overall PrEP use with any regimen increased from 27.6% in 2019 to 42.7% in 2023 (OR = 1.16, 95% CI = 1.15−1.18, p < 0.001). Among 12,922 participants who reported PrEP use in the last 6 months, the proportion reporting ED‐PrEP use increased from 7.6% in 2019 to 27.8% in 2023 (OR = 1.41, 95% CI = 1.37−1.46, p < 0.001) with those who reported daily PrEP decreasing from 92.4% to 63.3% (OR = 0.64, 95% CI = 0.62−0.66, p < 0.001). In a cross‐sectional sub‐sample in 2022–2023 (n = 8840), compared to ED‐PrEP users, non‐PrEP users were less likely to have received three or more HIV tests in the last 12 months (aRRR = 0.26, 95% CI = 0.22−0.31, p < 0.001), have 2−10 male sexual partners in the last 6 months (aRRR = 0.24, 95% CI = 0.14−0.41, p < 0.001) or 11 or more (aRRR = 0.26, 95% CI = 0.15−0.45, p < 0.001) compared to none, or to report condomless anal intercourse with casual partners (aRRR = 0.38, 95% CI = 0.32−0.46, p < 0.001). Compared to ED‐PrEP users, daily PrEP users were more likely to have received three of more HIV tests in the last year (aRRR = 3.73, 95% CI = 3.15−4.40, p < 0.001) and less likely to be born overseas and lived in Australia for less than 5 years compared to being born in Australia (aRRR = 0.64, 95% CI = 0.49−0.83, p = 0.001). Conclusions While daily PrEP remains the most common PrEP dosing regimen among GBMSM in Australia, there has been a steep increase in the proportion of PrEP users who are taking ED‐PrEP. Monitoring of PrEP use should continue to adapt to new dosing methods and future PrEP options. As ED‐PrEP use increases, further work is needed to ensure those taking ED‐PrEP are taking it effectively to prevent HIV.https://doi.org/10.1002/jia2.26398HIV preventionpre‐exposure prophylaxisgay and bisexual menmen who have sex with menevent‐driven PrEPon‐demand PrEP |
| spellingShingle | Curtis Chan Martin Holt Anthony K. J. Smith Timothy R. Broady James MacGibbon Limin Mao Ben Wilcock John Rule Benjamin R. Bavinton Increasing event‐driven HIV pre‐exposure prophylaxis use among gay, bisexual and other men who have sex with men in Australia: results from behavioural surveillance 2019–2023 Journal of the International AIDS Society HIV prevention pre‐exposure prophylaxis gay and bisexual men men who have sex with men event‐driven PrEP on‐demand PrEP |
| title | Increasing event‐driven HIV pre‐exposure prophylaxis use among gay, bisexual and other men who have sex with men in Australia: results from behavioural surveillance 2019–2023 |
| title_full | Increasing event‐driven HIV pre‐exposure prophylaxis use among gay, bisexual and other men who have sex with men in Australia: results from behavioural surveillance 2019–2023 |
| title_fullStr | Increasing event‐driven HIV pre‐exposure prophylaxis use among gay, bisexual and other men who have sex with men in Australia: results from behavioural surveillance 2019–2023 |
| title_full_unstemmed | Increasing event‐driven HIV pre‐exposure prophylaxis use among gay, bisexual and other men who have sex with men in Australia: results from behavioural surveillance 2019–2023 |
| title_short | Increasing event‐driven HIV pre‐exposure prophylaxis use among gay, bisexual and other men who have sex with men in Australia: results from behavioural surveillance 2019–2023 |
| title_sort | increasing event driven hiv pre exposure prophylaxis use among gay bisexual and other men who have sex with men in australia results from behavioural surveillance 2019 2023 |
| topic | HIV prevention pre‐exposure prophylaxis gay and bisexual men men who have sex with men event‐driven PrEP on‐demand PrEP |
| url | https://doi.org/10.1002/jia2.26398 |
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