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In comparison there were three new infections among the much smaller number of men who declined PrEP, yielding an incidence of 7.7% (95% CI 6.0-22.5). However, in two of these cases the men reported stopping PrEP at 50 and 272 days prior to seroconversion. There were five new HIV infections among the 178 men who accepted PrEP, for an incidence of 2.9% (95% CI 0.9-6.8). At the study’s midpoint about 70% of participants who accepted PrEP had protective drug levels in their plasma, according to a NIAID news release. Adherence of at least 90% was reported by 67%, 62%, and 67% at the respective time points.
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Self-reported adherence of at least 50% of doses was 85% at 4 weeks, 81% at 26 weeks, and 86% at 52 weeks. More than two-thirds (68%) remained on PrEP at 26 weeks. Cumulative PrEP uptake was highest in Chapel Hill (nearly 90%), followed by Washington, DC (nearly 80%) and Los Angeles (around 65%). All but one of the men (96%) who had an HIV-positive primary partner and 86% of those who had casual partners who were HIV-positive or of unknown status accepted PrEP. Men who agreed to take PrEP attended a median of 6 ‘C4’ sessions (range 3-8), while men who declined PrEP attended a median of 4 sessions (range 2-6).Ī majority of study participants (178 or 79%) accepted PrEP, usually starting it soon after enrolment.
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Participants were followed for 12 months. About one-third reported having a male primary partner (only three had female primary partners) and 73% said they had casual male partners the median number of male sexual partners in the past three months was three.Īll participants were offered once-daily oral Truvada along with client-centred care co-ordination or ‘C4’, a counselling approach to support PrEP use which combined service referral, linkage and follow-up to assist the men in addressing unmet psychosocial needs including substance use, homelessness, mental health and medical issues, and intimate partner violence. Nearly three-quarters identified as gay and 20% as bisexual. Over a quarter were unemployed or ‘on disability’ (receiving state disability payments), a third had been incarcerated, 25% had a high school education or less, nearly half had an annual income under $20,000 and 31% did not have health insurance. The study recruited 226 black MSM, of whom 209 (92%) completed 12 months of follow-up 40% were under 25 years of age. The study enrolled more than 200 HIV-negative men at sites in three cities: Chapel Hill, NC Los Angeles and Washington, DC. HPTN 073, conducted by the HIV Prevention Trials Network and funded by the US National Institute of Allergy and Infectious Diseases (NIAID) and National Institute on Drug Abuse, is one of the first studies to evaluate PrEP for black men who have sex with men (MSM).
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Refers to an individual’s entry into specialist HIV care after being diagnosed with HIV.