nach oben

Prevention Science

Erschienen in:

03.06.2017

Risk Perception, Sexual Behaviors, and PrEP Adherence Among Substance-Using Men Who Have Sex with Men: a Qualitative Study

verfasst von: Erik D. Storholm, Jonathan E. Volk, Julia L. Marcus, Michael J. Silverberg, Derek D. Satre

Erschienen in: Prevention Science | Ausgabe 6/2017

Einloggen, um Zugang zu erhalten

Abstract

The antiretroviral drug combination emtricitabine and tenofovir disoproxil fumarate (TDF/FTC) taken as pre-exposure prophylaxis (PrEP) is effective in preventing HIV infection, yet it also requires adherence and potentially decreases condom use. This study sought to examine these issues among a key population at risk of HIV infection, substance-using men who have sex with men (MSM). We conducted semi-structured interviews with an ethnically diverse sample of 30 young (aged 20–35) MSM prescribed PrEP within a large integrated healthcare system in San Francisco, who had reported recent drug use or hazardous drinking and one or more missed doses of PrEP. We explored participants’ risk perception and sexual risk behavior, drug and alcohol use, and PrEP adherence in the context of substance use. Interviews were transcribed and coded using a directed content analysis approach to identify key categories and commonalities, and differences across participants. Salient subcategories included positive psychological effects of being on PrEP (e.g., decreased anxiety, feelings of empowerment), social effects (e.g., reduced HIV stigma), and reduction in overall perceptions of HIV risk. While overall reported use of condoms went down and many reported a brief period of increased condomless sex following PrEP initiation, others continued condom use with most of their sexual partners. Contextual factors influencing their decision to engage in condomless sex included how well they knew the partner and whether the partner was on PrEP or HIV antiretroviral treatment. Factors associated with poor adherence included disruptions in daily routine and use of alcohol and methamphetamine. PrEP-prescribing clinicians should support their patients in making informed decisions about condom use and identifying strategies to maximize adherence in the context of substance use.

Abbas, U. L., Hood, G., Wetzel, A. W., & Mellors, J. W. (2011). Factors influencing the emergence and spread of HIV drug resistance arising from rollout of antiretroviral pre-exposure prophylaxis PrEP. PloS One, 6, e18165. doi:10.1371/journal.pone.0018165.CrossRefPubMedPubMedCentral

Anderson, P. L., Glidden, D. V., Liu, A., Buchbinder, S., Lama, J. R., Guanira, J. V., et al. (2012). Emtricitabine-tenofovir concentrations and pre-exposure prophylaxis efficacy in men who have sex with men. Science translational medicine, 4(151), 151ra125.

Azar, M. M., Springer, S. A., Meyer, J. P., & Altice, F. L. (2010). A systematic review of the impact of alcohol use disorders on HIV treatment outcomes, adherence to antiretroviral therapy and health care utilization. Drug and Alcohol Dependence, 112, 178–193. doi:10.1016/j.drugalcdep.2010.06.014.CrossRefPubMedPubMedCentral

Azar, P., Wood, E., Nguyen, P., Luma, M., Montaner, J., Kerr, T., & Milloy, M. J. (2015). Drug use patterns associated with risk of non-adherence to antiretroviral therapy among HIV-positive illicit drug users in a Canadian setting: A longitudinal analysis. BMC Infectious Diseases, 15, 193. doi:10.1186/s12879-015-0913-0.CrossRefPubMedPubMedCentral

Baeten, J. M., Donnell, D., Ndase, P., Mugo, N. R., Campbell, J. D., Wangisi, J., et al. (2012). Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. New England Journal of Medicine, 367, 399–410. doi:10.1056/NEJMoa1108524.CrossRefPubMedPubMedCentral

Brooks, R. A., Kaplan, R. L., Lieber, E., Landovitz, R. J., Lee, S. J., & Leibowitz, A. A. (2011). Motivators, concerns, and barriers to adoption of preexposure prophylaxis for HIV prevention among gay and bisexual men in HIV-serodiscordant male relationships. AIDS Care, 23, 1136–1145. doi:10.1080/09540121.2011.554528.CrossRefPubMedPubMedCentral

Brooks, R. A., Landovitz, R. J., Regan, R., Lee, S. J., & Allen Jr., V. C. (2015). Perceptions of and intentions to adopt HIV pre-exposure prophylaxis among black men who have sex with men in Los Angeles. International Journal of STD & AIDS, 26, 1040–1048. doi:10.1177/0956462415570159.CrossRef

Carlo Hojilla, J., Koester, K. A., Cohen, S. E., Buchbinder, S., Ladzekpo, D., Matheson, T., & Liu, A. Y. (2016). Sexual behavior, risk compensation, and HIV prevention strategies among participants in the San Francisco PrEP Demonstration Project: A qualitative analysis of counseling notes. AIDS and Behavior, 20, 1461–1469. doi:10.1007/s10461-015-1055-5.CrossRefPubMedPubMedCentral

Cassell, M. M., Halperin, D. T., Shelton, J. D., & Stanton, D. (2006). Risk compensation: The Achilles’ heel of innovations in HIV prevention? BMJ (Clinical Research Ed.), 332, 605–607. doi:10.1136/bmj.332.7541.605.CrossRef

Centers for Disease Control and Prevention. (2014). Preexposure prophylaxis for the prevention of HIV infection in the United States—2014. A Clinical Practice Guideline. Retrieved from http://www.cdc.gov/hiv/pdf/PrEPguidelines2014.pdf

Centers for Disease Control and Prevention. (2016). HIV Surveillance Report, 2015 (vol. 27). http://www.cdc.gov/hiv/library/reports/hiv-surveillance.html. Accessed [October, 2017]

Corbin, J., & Strauss, A. (2008). Basics of qualitative research (3rd ed.). Thousand Oaks: Sage.

Dawson, D. A. (2011). Defining risk drinking. Alcohol Research and Health, 34, 144–156.PubMedPubMedCentral

de Wit, J., Murphy, D., Lal, L., Audsley, J., Roth, N., Moore, R., … Wright, E. (2015). O19. 2 Pre-exposure prophylaxis and risk compensation: Evidence of decreased condom use at three-month follow-up among predominantly gay male participants in the VicPrEP study. Sexually Transmitted Infections, 91, A68-A68.

Donnell, D., Baeten, J. M., Bumpus, N. N., Brantley, J., Bangsberg, D. R., Haberer, J. E., et al. (2014). HIV protective efficacy and correlates of tenofovir blood concentrations in a clinical trial of PrEP for HIV prevention. Journal of Acquired Immune Deficiencies Syndrome, 66, 340–348. doi:10.1097/QAI.0000000000000172.CrossRef

Ellis, R. J., Childers, M. E., Cherner, M., Lazzaretto, D., Letendre, S., Grant, I., & Group, H. I. V. N. R. C. (2003). Increased human immunodeficiency virus loads in active methamphetamine users are explained by reduced effectiveness of antiretroviral therapy. Journal of Infectious Diseases, 188, 1820–1826. doi:10.1086/379894.CrossRefPubMed

Gibson, S., Crouch, P.-C., Hecht, J., Gagliano, J., Patriarca, T., Auerbach, J., … Hall, C. (2016). Eliminating barriers to increase uptake of PrEP in a community-based clinic in San Francisco. Paper presented at the International AIDS Conference, Durban, South Africa.

Golub, S. A., Kowalczyk, W., Weinberger, C. L., & Parsons, J. T. (2010). Preexposure prophylaxis and predicted condom use among high-risk men who have sex with men. Journal of Acquired Immune Deficiencies Syndrome, 54(5), 548–555. doi:10.1097/QAI.0b013e3181e19a54.CrossRef

Grant, R. M., Anderson, P. L., McMahan, V., Liu, A., Amico, K. R., Mehrotra, M., et al. (2014). Uptake of pre-exposure prophylaxis, sexual practices, and HIV incidence in men and transgender women who have sex with men: A cohort study. The Lancet. Infectious Diseases, 14(9), 820–829. doi:10.1016/S1473-3099(14)70847-3.CrossRefPubMed

Grant, R. M., & Koester, K. A. (2016). What people want from sex and preexposure prophylaxis. Current Opinion in HIV and AIDS, 11(1), 3–9. doi:10.1097/COH.0000000000000216.CrossRefPubMed

Grant, R. M., Lama, J. R., Anderson, P. L., McMahan, V., Liu, A. Y., Vargas, L., … iPrEx Study, T (2010). Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. New England Journal of Medicine, 363(27), 2587–2599. doi:http://dx.doi.org/10.1056/NEJMoa1011205

Haberer, J. E., Bangsberg, D. R., Baeten, J. M., Curran, K., Koechlin, F., Amico, K. R., et al. (2015). Defining success with HIV pre-exposure prophylaxis: A prevention-effective adherence paradigm. AIDS, 29, 1277–1285. doi:10.1097/QAD.0000000000000647.CrossRefPubMedPubMedCentral

Halkitis, P. N., Moeller, R. W., Siconolfi, D. E., Storholm, E. D., Solomon, T. M., & Bub, K. L. (2013). Measurement model exploring a syndemic in emerging adult gay and bisexual men. AIDS and Behavior, 17, 662–673. doi:10.1007/s10461-012-0273-3.CrossRefPubMedPubMedCentral

Hendershot, C. S., Stoner, S. A., Pantalone, D. W., & Simoni, J. M. (2009). Alcohol use and antiretroviral adherence: Review and meta-analysis. Journal of Acquired Immune Deficiencies Syndrome, 52, 180–202. doi:10.1097/QAI.0b013e3181b18b6e.CrossRef

Hinkin, C. H., Barclay, T. R., Castellon, S. A., Levine, A. J., Durvasula, R. S., Marion, S. D., et al. (2007). Drug use and medication adherence among HIV-1 infected individuals. AIDS and Behavior, 11, 185–194. doi:10.1007/s10461-006-9152-0.CrossRefPubMedPubMedCentral

Hogben, M., & Liddon, N. (2008). Disinhibition and risk compensation: Scope, definitions, and perspective. Sexually Transmitted Diseases, 35, 1009–1010. doi:10.1097/OLQ.0b013e31818eb752.CrossRefPubMed

Humeniuk, R., Henry-Edwards, S., Ali, R., Poznyak, V., & Monteiro, M. G. (2010). The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Manual for use in primary care. Retrieved from Geneva, Switzerland: http://whqlibdoc.who.int/publications/2010/9789241599382_eng.pdf

Landovitz, R. J., Kofron, R., & McCauley, M. (2016). The promise and pitfalls of long-acting injectable agents for HIV prevention. Current Opinion in HIV and AIDS, 11(1), 122–128.

Liu, A. Y., Cohen, S. E., Vittinghoff, E., Anderson, P. L., Doblecki-Lewis, S., Bacon, O., et al. (2016). Preexposure prophylaxis for HIV infection integrated with municipal- and community-based sexual health services. JAMA Internal Medicine, 176, 75–84. doi:10.1001/jamainternmed.2015.4683.CrossRefPubMedPubMedCentral

Liu, A. Y., Vittinghoff, E., Chillag, K., Mayer, K., Thompson, M., Grohskopf, L., et al. (2013). Sexual risk behavior among HIV-uninfected men who have sex with men participating in a tenofovir preexposure prophylaxis randomized trial in the United States. Journal of Acquired Immune Deficiencies Syndrome, 64, 87–94. doi:10.1097/QAI.0b013e31828f097a.CrossRef

Marcus, J. L., Glidden, D. V., Mayer, K. H., Liu, A. Y., Buchbinder, S. P., Amico, K. R., … Grant, R. M. (2013). No evidence of sexual risk compensation in the iPrEx trial of daily oral HIV preexposure prophylaxis. PLoS One, 8, e81997. doi:10.1371/journal.pone.0081997

McCormack, S., Dunn, D. T., Desai, M., Dolling, D. I., Gafos, M., Gilson, R., et al. (2016). Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): Effectiveness results from the pilot phase of a pragmatic open-label randomised trial. The Lancet, 387, 53–60. doi:10.1016/S0140-6736(15)00056-2.CrossRef

Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129, 674–697. doi:10.1037/0033-2909.129.5.674.CrossRefPubMedPubMedCentral

Molina, J. M., Capitant, C., Spire, B., Pialoux, G., Cotte, L., Charreau, I., et al., Group, A. I. S. (2015). On-demand preexposure prophylaxis in men at high risk for HIV-1 infection. New England Journal of Medicine, 373, 2237–2246. doi:10.1056/NEJMoa1506273.

Moore, D. J., Blackstone, K., Woods, S. P., Ellis, R. J., Atkinson, J. H., Heaton, R. K., et al., The Tmarc, G. (2012). Methamphetamine use and neuropsychiatric factors are associated with antiretroviral non-adherence. AIDS Care, 24, 1504–1513. doi:10.1080/09540121.2012.672718.

Mugwanya, K. K., Donnell, D., Celum, C., Thomas, K. K., Ndase, P., Mugo, N., et al. (2013). Sexual behaviour of heterosexual men and women receiving antiretroviral pre-exposure prophylaxis for HIV prevention: A longitudinal analysis. The Lancet. Infectious Diseases, 13, 1021–1028. doi:10.1016/S1473-3099(13)70226-3.CrossRefPubMedPubMedCentral

National Institute on Drug Abuse. NIDA Quick Screen V1.0 and Questions 1–8 of the NIDA-Modified ASSIST V2.0. Retrieved from https://www.drugabuse.gov/sites/default/files/pdf/nmassist.pdf

Newcomb, M. E., Mongrella, M. C., Weis, B., McMillen, S. J., & Mustanski, B. (2016). Partner disclosure of PrEP use and undetectable viral load on geosocial networking apps: frequency of disclosure and decisions about condomless sex. JAIDS Journal of Acquired Immune Deficiency Syndromes, 71(2), 200–206.

Parker, S., Chan, P. A., Oldenburg, C. E., Hoffmann, M., Poceta, J., Harvey, J., et al. (2015). Patient experiences of men who have sex with men using pre-exposure prophylaxis to prevent HIV infection. AIDS Patient Care and STDs, 29, 639–642.CrossRefPubMedPubMedCentral

Perez-Figueroa, R. E., Kapadia, F., Barton, S. C., Eddy, J. A., & Halkitis, P. N. (2015). Acceptability of PrEP uptake among racially/ethnically diverse young men who have sex with men: The P18 study. AIDS Education and Prevention, 27, 112–125. doi:10.1521/aeap.2015.27.2.112.CrossRefPubMedPubMedCentral

Pines, H. A., Gorbach, P. M., Weiss, R. E., Shoptaw, S., Landovitz, R. J., Javanbakht, M., et al. (2014). Sexual risk trajectories among MSM in the United States: Implications for pre-exposure prophylaxis delivery. Journal of Acquired Immune Deficiencies Syndrome, 65, 579–586. doi:10.1097/QAI.0000000000000101.CrossRef

Potter, W. J., & Levine-Donnerstein, D. (1999). Rethinking validity and reliability in content analysis. Journal of Applied Communication Research, 27(3), 258–284. doi:10.1080/00909889909365539.

Reback, C. J., Fletcher, J. B., Shoptaw, S., & Grella, C. E. (2013). Methamphetamine and other substance use trends among street-recruited men who have sex with men, from 2008 to 2011. Drug and Alcohol Dependence, 133, 262–265. doi:10.1016/j.drugalcdep.2013.06.007.CrossRefPubMedPubMedCentral

Shoptaw, S., & Reback, C. J. (2006). Associations between methamphetamine use and HIV among men who have sex with men: a model for guiding public policy. Journal of Urban Health, 83(6), 1151–1157.

Smith, D. K., Van Handel, M., Wolitski, R. J., Stryker, J. E., Hall, H. I., Prejean, J., et al. (2015). Vital signs: Estimated percentages and numbers of adults with indications for preexposure prophylaxis to prevent HIV acquisition—United States, 2015. MMWR Morbidity and Mortality Weekly Report, 64, 1291–1295. doi:10.15585/mmwr.mm6446a4.CrossRefPubMed

Storholm, E. D., Satre, D. D., Kapadia, F., & Halkitis, P. N. (2015). Depression, compulsive sexual behavior, and sexual risk-taking among urban young gay and bisexual men: The P18 Cohort Study [published online August 27, 2015]. Archives of Sexual Behavior. doi:10.1007/s10508-015-0566-5

U.S. Census Bureau. (2010). Bay Area Census: San Francisco City and County. Retrieved from February 2, 2017, from http://www.bayareacensus.ca.gov/counties/SanFranciscoCounty.htm

Volk, J. E., Marcus, J. L., Phengrasamy, T., Blechinger, D., Nguyen, D. P., Follansbee, S., & Hare, C. B. (2015). No new HIV infections with increasing use of HIV preexposure prophylaxis in a clinical practice setting. Clinical and Infectious Diseases, 61, 1601–1603. doi:10.1093/cid/civ778.CrossRef

Vosburgh, H. W., Mansergh, G., Sullivan, P. S., & Purcell, D. W. (2012). A review of the literature on event-level substance use and sexual risk behavior among men who have sex with men. AIDS and Behavior, 16(6), 1394–1410.

Woolf, S. E., & Maisto, S. A. (2009). Alcohol use and risk of HIV infection among men who have sex with men. AIDS and Behavior, 13(4), 757–782.

Titel: Risk Perception, Sexual Behaviors, and PrEP Adherence Among Substance-Using Men Who Have Sex with Men: a Qualitative Study
verfasst von: Erik D. Storholm
Jonathan E. Volk
Julia L. Marcus
Michael J. Silverberg
Derek D. Satre
Publikationsdatum: 03.06.2017
Verlag: Springer US
Erschienen in: Prevention Science / Ausgabe 6/2017
Print ISSN: 1389-4986
Elektronische ISSN: 1573-6695
DOI: https://doi.org/10.1007/s11121-017-0799-8

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Risk Perception, Sexual Behaviors, and PrEP Adherence Among Substance-Using Men Who Have Sex with Men: a Qualitative Study

Abstract

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 6/2017

Expanding the Cultural Adaptation Framework for Population-Level Impact

Directions for the Advancement of Culturally Adapted Preventive Interventions: Local Adaptations, Engagement, and Sustainability

Cultural Adaptations: Conceptual, Ethical, Contextual, and Methodological Issues for Working with Ethnocultural and Majority-World Populations

Prevalence of Past-Year Sexual Assault Victimization Among Undergraduate Students: Exploring Differences by and Intersections of Gender Identity, Sexual Identity, and Race/Ethnicity

Different Strokes for Different Folks? Contrasting Approaches to Cultural Adaptation of Parenting Interventions

Alternatives to Randomized Control Trial Designs for Community-Based Prevention Evaluation