Oral pre-exposure prophylaxis uptake, adherence, and adverse events among South African men who have sex with men and transgender women

Southern African Journal of HIV Medicine

Field Value
Title Oral pre-exposure prophylaxis uptake, adherence, and adverse events among South African men who have sex with men and transgender women
Creator Bekker, Linda-Gail Giovenco, Danielle Baral, Stefan Dominguez, Karen Valencia, Rachel Sanchez, Travis McNaghten, A.D. Zahn, Ryan Yah, Clarence S. Sokhela, Zinhle Kaplan, Richard Phaswana-Mafuya, Refliwe N. Beyrer, Chris Sullivan, Patrick S.
Subject Public Health; Epidemiology; Clinical Medicine HIV; men who have sex with men; transgender women; sexually transmitted infections; pre-exposure prophylaxis; HIV prevention; South Africa
Description Background: HIV prevention programmes that include pre-exposure prophylaxis (PrEP) for men who have sex with men (MSM) and transgender women (TGW) in South Africa have not been widely implemented.Objectives: The authors examined oral PrEP uptake, adherence, and adverse events among HIV-uninfected MSM and TGW to inform intervention acceptability and feasibility.Method: In 2015, MSM and TGW in two South African cities were offered a comprehensive package of HIV prevention services, including daily oral PrEP, and were followed for one year. Different models of PrEP delivery were used at each site. Adherence was measured using self-report and pill-count data and tenofovir-diphosphate (TFV-DP) concentrations.Results: Among 135 participants who were eligible for PrEP, 82 (61%) initiated PrEP, of whom 67 (82%) were on PrEP at study end. Participants were on PrEP for a median of 294 out of 314.5 possible days (93% protected days). The median time from PrEP initiation to discontinuation or study end was 305 days (interquartile range: 232–325 days). Across the follow-up time points, 57% – 72% of participants self-reported taking protective levels of PrEP and 59% – 74% were adherent to PrEP as indicated by pill counts. Fewer (≤ 18%) achieved protective TFV-DP concentrations of ≥ 700 fmol/punch in dried blood spots. Side effects, while typically mild, were the most commonly cited reason by participants for early PrEP discontinuation.Conclusion: Many MSM and TGW initiated and maintained PrEP, demonstrating that PrEP can be successfully delivered to South African MSM and TGW in diverse programmatic contexts. Biologic adherence measures suggest MSM and TGW may experience challenges taking PrEP regularly. Counselling for coping with side effects and motivating daily pill taking is recommended to support South African MSM and TGW in achieving protection with PrEP.
Publisher AOSIS
Date 2022-11-08
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — —
Format text/html application/epub+zip text/xml application/pdf application/pdf
Identifier 10.4102/sajhivmed.v23i1.1405
Source Southern African Journal of HIV Medicine; Vol 23, No 1 (2022); 9 pages 2078-6751 1608-9693
Language eng
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https://sajhivmed.org.za/index.php/hivmed/article/view/1405/2936 https://sajhivmed.org.za/index.php/hivmed/article/view/1405/2937 https://sajhivmed.org.za/index.php/hivmed/article/view/1405/2938 https://sajhivmed.org.za/index.php/hivmed/article/view/1405/2944 https://sajhivmed.org.za/index.php/hivmed/article/view/1405/2939
Coverage South Africa — Men
Rights Copyright (c) 2022 Linda-Gail Bekker, Danielle Giovenco, Stefan Baral, Karen Dominguez, Rachel Valencia, Travis Sanchez, A.D. McNaghten, Ryan Zahn, Clarence S. Yah, Zinhle Sokhela, Richard Kaplan, Refliwe N. Phaswana-Mafuya, Chris Beyrer, Patrick S. Sullivan https://creativecommons.org/licenses/by/4.0