May 3, 2016

Which men stand to benefit most from access to PrEP?

Written by Michael Carter

Gay men with rectal STIs and who have more unprotected receptive anal sex with more partners most likely to benefit from PrEP, PROUD study analysis shows

This post originally appeared on NAM AIDSMAP.

New data from the PROUD pre-exposure prophylaxis (PrEP) study have identified the characteristics of the gay and other men who have sex men who are most likely to benefit from PrEP. Study participants were randomised to receive immediate or deferred PrEP. Analysis of the baseline sexual characteristics of men in the differed arm who became infected with HIV showed that a rectal sexually transmitted infection (STI) and reporting recent unprotected anal sex with two or more partners were associated with especially high HIV incidence rates. Findings were reported to the recent conference of the British HIV Association (BHIVA) in Manchester.

The PROUD trial recruited 544 MSM in the UK. They were randomised to receive either immediate PrEP or deferred treatment. There were no infections in the PrEP arm.

In the present analysis, investigators focused their attention on men in the deferred arm who became infected with HIV. Their aim was to identify the characteristics of men at highest risk of HIV who would most benefit from PrEP. They considered baseline characteristics including diagnosis with a rectal STI, number of recent unprotected receptive anal sex partners, use of drugs during sex (Chemsex), use of post-exposure prophylaxis (PEP) and relationship status.

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