Universidad Peruana Cayetano Heredia

Same-day initiation of oral pre-exposure prophylaxis among gay, bisexual, and other cisgender men who have sex with men and transgender women in Brazil, Mexico, and Peru (ImPrEP): a prospective, single-arm, open-label, multicentre implementation study.

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dc.contributor.author Veloso, Valdilea G.
dc.contributor.author Caceres Palacios, Carlos Fernando
dc.contributor.author Hoagland, Brenda
dc.contributor.author Moreira, Ronaldo I
dc.contributor.author Vega-Ramirez, Hamid
dc.contributor.author Konda, Kelika A.
dc.contributor.author Leite, Iuri C.
dc.contributor.author Bautista-Arredondo, Sergio
dc.contributor.author Vinicius de Lacerda, Marcus
dc.contributor.author Valdez Madruga, Jose
dc.contributor.author Farias, Alessandro
dc.contributor.author Lima, Josue N
dc.contributor.author Zonta, Ronaldo
dc.contributor.author Lauria, Lilian
dc.contributor.author Tamayo, Cesar Vidal Osco
dc.contributor.author Flores, Hector Javier Salvatierra
dc.contributor.author Santa Cruz, Yovanna Margot Cabrera
dc.contributor.author Aguayo, Ricardo Martin Moreno
dc.contributor.author Cunha, Marcelo
dc.contributor.author Moreira, Julio
dc.contributor.author Makkeda, Alessandra Ramos
dc.contributor.author Diaz, Steven
dc.contributor.author Guanira, Juan V.
dc.contributor.author Vermandere, Heleen
dc.contributor.author Benedetti, Marcos
dc.contributor.author Ingold, Heather L.
dc.contributor.author Pimenta, M. Cristina
dc.contributor.author Torres, Thiago S.
dc.contributor.author Grinsztejn, Beatriz
dc.contributor.author ImPrEP Study Group
dc.date.accessioned 2023-01-06T13:40:11Z
dc.date.available 2023-01-06T13:40:11Z
dc.date.issued 2022
dc.identifier.uri https://hdl.handle.net/20.500.12866/12983
dc.description.abstract Background: Although gay, bisexual, and other cisgender men who have sex with men (MSM) and transgender women have the highest HIV burden in Latin America, pre-exposure prophylaxis (PrEP) implementation is poor. We aimed to assess the feasibility of same-day oral PrEP delivery in Brazil, Mexico, and Peru. Methods: Implementation PrEP (ImPrEP) was a prospective, single-arm, open-label, multicentre PrEP implementation study conducted in Brazil (14 sites), Mexico (four sites), and Peru (ten sites). MSM and transgender women were eligible to participate if they were aged 18 years or older, HIV-negative, and reported one or more prespecified criteria. Enrolled participants received same-day initiation of daily oral PrEP (tenofovir disoproxil fumarate [300 mg] coformulated with emtricitabine [200 mg]). Follow-up visits were scheduled at week 4 and quarterly thereafter. We used logistic regression models to identify factors associated with early loss to follow-up (not returning after enrolment), PrEP adherence (medication possession ratio ≥0·6), and long-term PrEP engagement (attending three or more visits within 52 weeks). This study is registered at the Brazilian Registry of Clinical Trials, U1111-1217-6021. Findings: From Feb 6, 2018, to June 30, 2021, 9979 participants were screened and 9509 were enrolled (Brazil n=3928, Mexico n=3288, and Peru n=2293). 543 (5·7%) participants were transgender women, 8966 (94·3%) were cisgender men, and 2481 (26·1%) were aged 18–24 years. There were 12 185·25 person-years of follow-up. 795 (8·4%) of 9509 participants had early loss to follow-up, 6477 (68·1%) of 9509 were adherent to PrEP, and 5783 (70·3%) of 8225 had long-term PrEP engagement. Transgender women (adjusted odds ratio 1·60, 95% CI 1·20–2·14), participants aged 18–24 years (1·80, 1·49–2·18), and participants with primary education (2·18, 1·29–3·68) had increased odds of early loss to follow-up. Transgender women (0·56, 0·46–0·70), participants aged 18–24 years (0·52, 0·46–0·58), and those with primary education (0·60, 0·40–0·91) had lower odds of PrEP adherence. Transgender women (0·56, 0·45–0·71), participants aged 18–24 years (0·56, 0·49–0·64), and those with secondary education (0·74, 0·68–0·86) had lower odds of long-term PrEP engagement. HIV incidence was 0·85 per 100 person-years (95% CI 0·70–1·03) and was higher for transgender women, participants from Peru, those aged 18–24 years, Black and mixed-race participants, and participants who were non-adherent to PrEP. en_US
dc.language.iso eng
dc.publisher Elsevier
dc.relation.ispartofseries Lancet. HIV
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Oral en_US
dc.subject Prophylaxis en_US
dc.subject Gay en_US
dc.subject Bisexual en_US
dc.subject Cisgender en_US
dc.subject Sex with men en_US
dc.subject Transgender women en_US
dc.subject Brazil en_US
dc.subject Mexico en_US
dc.subject Peru en_US
dc.title Same-day initiation of oral pre-exposure prophylaxis among gay, bisexual, and other cisgender men who have sex with men and transgender women in Brazil, Mexico, and Peru (ImPrEP): a prospective, single-arm, open-label, multicentre implementation study. en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1016/S2352-3018(22)00331-9
dc.relation.issn 2352-3018


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