XIX International AIDS Conference


TUPDC03 PEP, PrEP and HIV Testing
  Oral Poster Discussion Session : Track C
Venue: Mini Room 9
Time: 24.07.2012, 13:00 - 14:00
Co-Chairs: Susan Buchbinder, United States
Bruno Spire, France
 
 

13:00
TUPDC0301
Abstract
Willingness to take daily pre-exposure prophylaxis (PrEP) among MSM in two HIV epicenters in the United States
L. Metsch1, I. Kuo2, M. Lalota3, G. Phillips II2, G. Cardenas1, A. Castel2, D. Forrest1, T. West2, M. Pereyra1, Y. Jia2, M. Kolber4, J. Opoku2, M. Magnus2
1University of Miami Miller School of Medicine, Department of Epidemiology and Public Health, Miami, United States, 2George Washington University Medical Center, Division of Infectious Diseases, Washington, United States, 3Florida Department of Health, Tallahassee, United States, 4University of Miami Miller School of Medicine, Medicine, Miami, United States
L. Metsch, United States

13:05
TUPDC0302
Abstract
Powerpoint
Perceptions and attitudes about PrEP among seronegative partners and the potential of sexual disinhibition associated with the use of PrEP
A. Tripathi1, O. Whiteside2, C. Scanlon2, W. Duffus2
1University of South Carolina, Epidemiology and Biostatistics, Columbia, United States, 2South Carolina Department of Health and Environmental Control, Bureau of Disease Control, Columbia, United States
W. Duffus, United States

13:10
TUPDC0303
Abstract
Powerpoint
Acceptability of oral intermittent pre-exposure prophylaxis as a biomedical HIV prevention strategy: results from the South African ADAPT (HPTN 067) Preparatory Study
D. Mark1, K.R. Amico2,3, M. Wallace1, S. Roux1, R. Grant4,5, R. Wood1, L.-G. Bekker1
1Desmond Tutu HIV Centre, Institute of Infectious Disease and Molecular Medicine and Department of Medicine, University of Cape Town, Cape Town, South Africa, 2Applied Health Research, Connecticut, United States, 3Center for Health Intervention and Prevention, University of Connecticut, Connecticut, United States, 4Gladstone Institute of Virology and Immunology, San Francisco, United States, 5University of California, San Francisco, United States
L. Bekker, South Africa

13:15
TUPDC0304
Abstract
Powerpoint
Use of a rapid HIV home test to screen potential sexual partners prevents HIV exposure in a high-risk sample of MSM
A. Carballo-Diéguez, I. Balan, T. Frasca, C. Dolezal, J. Valladares
HIV Center for Clinical and Behavioral Studies, NYS Psychiatric Institute and Columbia University, New York, United States
A. Carballo-Diéguez, United States

13:20
TUPDC0305
Abstract
Powerpoint
Experience of a NYC hospital with non-occupational post-exposure prophylaxis (nPEP)
A. Urbina1, G. Osorio1, E. Daniel2,3, P. Galatowitsch4, B. Riggan5, Z. Hennessey5, V. Sharp1
1Center for Comprehensive Care, St Luke's Roosevelt Hospital, Medicine, New York, United States, 2Center for Comprehensive Care, St Luke's Roosevelt Hospital, Emergency Medicine, New York, United States, 3Columbia University College of Physicians and Surgeons, Emergency Medicine, New York, United States, 4HealthClear Strategies, New York, United States, 5Center for Comprehensive Care, St Luke's Roosevelt Hospital, New York, United States
A. Urbina, United States

13:25
TUPDC0306
Abstract
Project PrEP Talk: an in-depth qualitative analysis of PrEP acceptability, expectations and risk compensation beliefs among United States MSM
K. Underhill1, K. Morrow2, D. Operario3, R. Ducharme4, C. Kuo3, K. Mayer5
1Yale University, New Haven, United States, 2Brown University - The Miriam Hospital, Department of Psychiatry & Human Behavior, Providence, United States, 3Brown University, Department of Community Health, Providence, United States, 4The Miriam Hospital, Providence, United States, 5The Fenway Institute, Boston, United States
K. Underhill, United States

13:30
Moderated discussion



Powerpoints presentations
Perceptions and attitudes about PrEP among seronegative partners and the potential of sexual disinhibition associated with the use of PrEP - Wayne Duffus

Acceptability of oral intermittent pre-exposure prophylaxis as a biomedical HIV prevention strategy: results from the South African ADAPT (HPTN 067) Preparatory Study - Linda-Gail Bekker

Use of a rapid HIV home test to screen potential sexual partners prevents HIV exposure in a high-risk sample of MSM - Alex Carballo-Diéguez

Experience of a NYC hospital with non-occupational post-exposure prophylaxis (nPEP) - Antonio Urbina



Rapporteur report

Track C report by Albert Liu


This oral poster session covers several studies on PrEP, PEP, and home HIV testing.  PEP involves a 28 day course of ARVs after an exposure to prevent HIV infection, and PrEP involves starting ARVs before exposure and continued during periods of risk.  PrEP with FTC/TDF and the home HIV test were both approved recently by the FDA.

 PrEP awareness among MSM participating in the National Behavioral Surveillance Study was low in Miami (15%) and Washington, DC (30%).  Almost half of MSM in Miami and about two-thirds in DC reported willingness to take PrEP, if available at no cost.  Non-injection drug use (OR = 0.59) was associated with decreased willingness to use PrEP in Miami, but increased willingness in DC (OR=1.67).  In DC, older age and having fewer sex partners was associated with decreased PrEP acceptability.

 Interest in PrEP was also assessed among 89 seronegative partners in a Ryan White HIV Clinic in South Carolina from 2010-2011.  The majority (94%) expressed willingness to use PrEP; however, 26% suggested they would be more likely to have unprotected sex with an HIV-positive partner while taking PrEP, and 27% suggested it would be difficult to take a daily pill.

Acceptability of intermittent PrEP was assessed in South African men and women using mixed methods.  The primary facilitator of PrEP uptake was its potential for nonconsensual use, while barriers included perception of antiretrovirals as treatment, stigma, and potential side effects and risk compensation.  iPrEP was favored over daily PrEP for perceived ease of use with fewer dosing days.  The median number of sex days/week was 2 (more likely on weekends), and approximately 2/3 of sex days were planned.

The feasibility and acceptability of home HIV rapid testing to screen sexual partners was evaluated in high-risk MSM in New York City (NYC).  A diverse sample of 27 men were provided test kits, and 101/124 partners agreed to testing -- 10 sexual partners were found to be HIV-infected, and no unprotected sex occurred with these partners.  The home HIV test was found to be highly acceptable, and some reported the home test kit shifted perceptions of risk and led to changes in risk practices.  Few social harms were reported, though audience members highlighted the importance of considering potential issues around stigma.

Experience with non-occupational post-exposure prophylaxis (nPEP) in a NYC based hospital was also presented.  Overall 116/134 (84%) of patients referred to the outpatient program completed the 4 week PEP course.  One participant seroconverted; this patient started nPEP 32 hours post-exposure.  A multi-disciplinary approach was helpful in coordinating care, follow-up, and supportive counseling.  The audience and panel discussed the importance of tolerability of PEP and PrEP regimens.

Qualitative data from focus groups with MSM in Rhode Island showed that while PrEP knowledge was low, the majority were willing to use PrEP.  Men reported a wide range of motivations and expected benefits with using PrEP.  Potential benefits included increased intimacy with partners, risk-reduction for HIV-negative partners, and empowerment of the community, and concerns included potential interactions with drug/alcohol, side effects, and concerns about confidentiality.  The FDA approval of PrEP was important for some men but not others, and was perceived to have a big impact on financing and insurance.




   

    The organizers reserve the right to amend the programme.


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