Association of HIV Preexposure Prophylaxis Use With HIV Incidence Among Men Who Have Sex With Men in China A Nonrandomized Controlled Trial

Wang, Hongyi1,2,3,4; Wang, Zixin5; Huang, Xiaojie6; Chen, Yaokai7; Wang, Hui8; Cui, Sitong1,2,3,4; Zhang, Jing1,2,3,4; Chu, Zhenxing1,2,3,4; Hu, Qinghai1,2,3,4; Ding, Haibo1,2,3,4; Qian, Hanzhu9; Zou, Huachun10; Tang, Weiming11; Gao, Yangyang1,2,3,4; Jin, Xia1,2,3,4; Liu, Zhaozhen2,4; Zhang, Lukun8; Zhao, Jin12; He, Xiaoqing7; Jiang, Yongjun1,2,3,4; Geng, Wenqing1,2,3,4; Xu, Junjie1,2,3,4; Shang, Hong1,2,3,4

2022-02-16

10.1001/jamanetworkopen.2021.48782

JAMA Network Open   影响因子和分区

2574-3805

["IMPORTANCE Evidence on HIV preexposure prophylaxis (PrEP) among Chinese men who have sex with men (MSM) is critical to guide its large-scale implementation in low- and middle-income countries.","OBJECTIVE To evaluate incident HIV infection, adherence, safety, and changes in sexual behaviors among MSM using daily PrEP (D-PrEP) and event-driven PrEP (ED-PrEP) in 4 cities in China.","DESIGN, SETTING, AND PARTICIPANTS This nonrandomized controlled trial was conducted among HIV-seronegative MSM from December 11, 2018, to November 30, 2020, in Beijing, Shenyang, Chongqing, and Shenzhen. Participants self-chose D-PrEP or ED-PrEP regimens at baseline and could switch regimens during the 12-month study period. HIV-negative MSM who declined to initiate PrEP (nonusers) in the same cities joined a separate parallel prospective cohort and served as control individuals.","INTERVENTIONS PrEP consisted of coformulated tenofovir disoproxil fumarate, 300 mg, and emtricitabine, 200 mg.","MAIN OUTCOMES AND MEASURES The main outcome was incident HIV infection. Poisson regression was used to obtain the HIV incidence rate ratio (IRR).","RESULTS A total of 1530 MSM were included in the analysis (median age, 30 [IQR, 25-37] years). At baseline, 520 MSM chose D-PrEP (median age, 29 [IQR, 25-35] years) and 503 chose ED-PrEP (median age, 29 [IQR, 25-36] years). The median HIV Risk Index score was 18 (IQR, 12-22) among D-PrEP users and 18 (IQR, 11-22) among ED-PrEP users. Among 507 PrEP nonusers, the median age was 33 (IQR, 27-43) years, and the median HIV Risk Index score was 12 (IQR, 7-18). Although PrEP users had more baseline behaviors associated with HIV risk, the HIV incidence was lower among all PrEP users (adjusted IRR, 0.09 [95% CI, 0.04-0.21]), ED-PrEP users (adjusted IRR, 0.05 [95% CI, 0.01-0.22]), and D-PrEP users (adjusted IRR, 0.12 [95% CI, 0.04-0.33]) compared with PrEP nonusers. There was no difference in HIV incidence between D-PrEP users and ED-PrEP users (IRR, 0.33 [95% CI, 0.06-2.04]). Event-driven PrEP users consumed 40% fewer tablets than D-PrEP users during the study period. Adherence, defined as the proportion of self-reported days with sexual intercourse in which PrEP was taken according to prescription of at least 90%, increased over time among ED-PrEP users (from 57.4% to 77.8%; P < .001 for trend) and decreased over time among D-PrEP users (from 75.1% to 72.1%; P = .02 for trend). Daily PrEP users reported fewer adverse events than ED-PrEP users (193 of 520 [37.1%] vs 241 of 503 [47.9%]).","CONCLUSIONS AND RELEVANCE The findings of this study suggest that D-PrEP and ED-PrEP regimens are associated with lower incidence of HIV and a good safety profile among high-risk MSM in China."]

SCI

英语

其他

Mega-Projects of National Science Research (13th Five-Year Plan)[2017ZX10201101] ; National Natural Science Foundation of China[81872674]

General & Internal Medicine

Medicine, General & Internal

WOS:000757514000006

AMER MEDICAL ASSOC

Web of Science

1.China Med Univ, NHC Key Lab Aids Immunol, Natl Clin Res Ctr Lab Med, Affiliated Hosp 1, 155 Nanjing N St, Shenyang 110001, Liaoning, Peoples R China
2.Chinese Acad Med Sci, Key Lab AIDS Immunol, Shenyang, Peoples R China
3.Key Lab AIDS Immunol Liaoning Prov, Shenyang, Peoples R China
4.Collaborat Innovat Ctr Diag & Treatment Infect Di, Hangzhou, Peoples R China
5.Chinese Univ Hong Kong, Fac Med, JC Sch Publ Hlth & Primary Care, Hong Kong, Peoples R China
6.Capital Med Univ, Beijing Youan Hosp, Ctr Infect Dis, Beijing, Peoples R China
7.Chongqing Publ Hlth Med Ctr, Chongqing, Peoples R China
8.Southern Univ Sci & Technol, Natl Clin Ctr Infect Dis, Dept Infect Dis, Peoples Hosp 3,Affiliated Hosp 2, Shenzhen, Peoples R China
9.Yale Univ, Sch Publ Hlth, New Haven, CT USA
10.Sun Yat Sen Univ, Sch Publ Hlth Shenzhen, Shenzhen, Peoples R China
11.Univ North Carolina Chapel Hill Project China, Guangzhou, Peoples R China
12.Shenzhen Ctr Dis Control & Prevent Shenzhen, Shenzhen, Guangdong, Peoples R China

Wang, Hongyi,Wang, Zixin,Huang, Xiaojie,et al. Association of HIV Preexposure Prophylaxis Use With HIV Incidence Among Men Who Have Sex With Men in China A Nonrandomized Controlled Trial[J]. JAMA Network Open,2022,5(2).

Wang, Hongyi.,Wang, Zixin.,Huang, Xiaojie.,Chen, Yaokai.,Wang, Hui.,...&Shang, Hong.(2022).Association of HIV Preexposure Prophylaxis Use With HIV Incidence Among Men Who Have Sex With Men in China A Nonrandomized Controlled Trial.JAMA Network Open,5(2).

Wang, Hongyi,et al."Association of HIV Preexposure Prophylaxis Use With HIV Incidence Among Men Who Have Sex With Men in China A Nonrandomized Controlled Trial".JAMA Network Open 5.2(2022).