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41. The cost-effectiveness of HIV pre-exposure prophylaxis in men who have sex with men and transgender women at high risk of HIV infection in Brazil. (PubMed)

The cost-effectiveness of HIV pre-exposure prophylaxis in men who have sex with men and transgender women at high risk of HIV infection in Brazil. Men who have sex with men (MSM) and transgender women (TGW) in Brazil experience high rates of HIV infection. We examined the clinical and economic outcomes of implementing a pre-exposure prophylaxis (PrEP) programme in these populations.We used the Cost-Effectiveness of Preventing AIDS Complications (CEPAC)-International model of HIV prevention (...) and treatment to evaluate two strategies: the current standard of care (SOC) in Brazil, including universal ART access (No PrEP strategy); and the current SOC plus daily tenofovir/emtracitabine PrEP (PrEP strategy) until age 50. Mean age (31 years, SD 8.4 years), age-stratified annual HIV incidence (age ≤ 40 years: 4.3/100 PY; age > 40 years: 1.0/100 PY), PrEP effectiveness (43% HIV incidence reduction) and PrEP drug costs ($23/month) were from Brazil-based sources. The analysis focused on direct medical

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2018 Journal of the International AIDS Society

42. Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine HIV pre-exposure prophylaxis: clinical guidelines. Update April 2018 (PubMed)

Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine HIV pre-exposure prophylaxis: clinical guidelines. Update April 2018 Daily use of coformulated tenofovir and emtricitabine for HIV pre-exposure prophylaxis (PrEP) by populations at high risk of HIV infection is now recommended in guidelines from the United States, Europe and Australia and globally through the 2015 WHO guidelines. These 2017 Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine's (ASHM (...) are seeking PrEP•Assist clinicians in commencing and monitoring patients on PrEP including PrEP dosing schedules, management of side-effects and toxicity, use of PrEP in pregnancy and in chronic hepatitis B infection and how to cease PrEP Daily PrEP with co-formulated tenofovir and emtricitabine, used continuously or for shorter periods of time, is recommended in these guidelines as a key HIV-prevention option for men who have sex with men (MSM), transgender men and women, heterosexual men and women

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2018 Journal of virus eradication

43. Missed Opportunities to Pre-exposure Prophylaxis for HIV Infection on Person Newly Diagnosed With HIV

Missed Opportunities to Pre-exposure Prophylaxis for HIV Infection on Person Newly Diagnosed With HIV Missed Opportunities to Pre-exposure Prophylaxis for HIV Infection on Person Newly Diagnosed With HIV - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please (...) remove one or more studies before adding more. Missed Opportunities to Pre-exposure Prophylaxis for HIV Infection on Person Newly Diagnosed With HIV The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03671291 Recruitment

2018 Clinical Trials

44. Repeated False-Positive HIV Test Results in a Patient Taking HIV Pre-Exposure Prophylaxis (PubMed)

Repeated False-Positive HIV Test Results in a Patient Taking HIV Pre-Exposure Prophylaxis Regular HIV testing is required to ensure the safety of HIV pre-exposure prophylaxis (PrEP). We describe and discuss a series of false-positive HIV test results from an individual receiving PrEP. The expansion of PrEP will likely result in greater numbers of false-positive test results that may pose challenges for interpretation.

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2018 Open forum infectious diseases

45. Association between exposure to antiretroviral drugs and the incidence of hypertension in HIV-positive persons: the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study. (PubMed)

Association between exposure to antiretroviral drugs and the incidence of hypertension in HIV-positive persons: the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study. Previous studies have suggested that hypertension in HIV-positive individuals is associated primarily with traditional risk factors such as older age, diabetes and dyslipidaemia. However, controversy remains as to whether exposure to antiretroviral (ARV) drugs poses additional risk, and we investigated (...) this question in the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) cohort.The incidence of hypertension [systolic blood pressure (BP) > 140 and/or diastolic BP > 90 mmHg and/or initiation of antihypertensive treatment] was determined overall and in strata defined by demographic, metabolic and HIV-related factors, including cumulative exposure to each individual ARV drug. Predictors of hypertension were identified using uni- and multivariable Poisson regression models.Of 33 278 included persons

2018 HIV medicine

46. HIV Exposure and Formula Feeding Predict Under-2 Mortality in HIV-Uninfected Children, Botswana. (PubMed)

HIV Exposure and Formula Feeding Predict Under-2 Mortality in HIV-Uninfected Children, Botswana. To prospectively assess rates and detailed predictors of morbidity and mortality among HIV-exposed uninfected children and HIV-unexposed children in Botswana in a more recent era.We enrolled HIV-infected and HIV-uninfected mothers and their children in the prospective observational Tshipidi study at 2 sites (1 city and 1 village) in Botswana from May 2010-July 2012. Live-born children (...) , and congenital anomaly were also associated with mortality (in separate analyses), but maternal socioeconomic factors, depression, substance use, and social support were not significant predictors.The strongest predictors of 24-month mortality among children in Botswana were HIV exposure and formula feeding, although the relative contribution of these factors to child health could not be separated.Copyright © 2018 Elsevier Inc. All rights reserved.

2018 Journal of Pediatrics

47. Sexually Acquired Hepatitis C Infection in HIV-uninfected Men Who Have Sex with Men Using Pre-exposure Prophylaxis Against HIV. (PubMed)

Sexually Acquired Hepatitis C Infection in HIV-uninfected Men Who Have Sex with Men Using Pre-exposure Prophylaxis Against HIV. Sexually-acquired HCV infections among HIV-uninfected men who have sex with men (MSM) have been rare. With the introduction of pre-exposure prophylaxis (PrEP) against HIV, we hypothesized that these infections would increase. Between 2013 and 2018 we diagnosed 15 likely sexually-acquired HCV infections among 14 MSM using PrEP. Most (87%) were asymptomatic, detected

2018 Journal of Infectious Diseases

48. Evaluation of PrEP eligibility criteria using sexually transmissible infections as HIV risk markers at enrolment in PrEPX, a large Australian HIV pre-exposure prophylaxis trial. (PubMed)

Evaluation of PrEP eligibility criteria using sexually transmissible infections as HIV risk markers at enrolment in PrEPX, a large Australian HIV pre-exposure prophylaxis trial. To determine participants' human immunodeficiency virus (HIV) risk, the Australian preexposure prophylaxis (PreEPX) trial used 6 eligibility criteria derived from the US Centers for Disease Control and Prevention PrEP guidelines. Participants who fulfilled no eligibility criteria could be enrolled if clinically assessed (...) to need PrEP. This study evaluated whether PREPX eligibility criteria correlated with biological HIV risk markers-namely, syphilis, anorectal chlamydia, or anorectal gonorrhea (sexually transmitted infections [STIs]).We calculated adjusted odds ratios (aORs) to assess whether eligibility criteria predicted STI diagnoses at enrollment.We included 1774 participants, of whom 10.2% tested positive for STIs. Eligibility criteria predicted STI diagnoses as follows: (1) aOR 2.5 (95% confidence interval [CI

2018 Clinical Infectious Diseases

49. HIV post-exposure prophylaxis awareness and use among men who have sex with men: a systematic review and meta-analysis

HIV post-exposure prophylaxis awareness and use among men who have sex with men: a systematic review and meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any

2019 PROSPERO

50. Systematic review of correlates of HIV pre-exposure prophylaxis (PrEP) prescription by health care providers in the United States (U.S.)

Systematic review of correlates of HIV pre-exposure prophylaxis (PrEP) prescription by health care providers in the United States (U.S.) Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration

2019 PROSPERO

51. Acceptability, barriers and facilitators to access to HIV pre-exposure prophylaxis (PrEP) in African migrants in high-income countries: a systematic review

Acceptability, barriers and facilitators to access to HIV pre-exposure prophylaxis (PrEP) in African migrants in high-income countries: a systematic review Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content

2019 PROSPERO

52. Are CDC Guidelines for Pre-Exposure Prophylaxis Specific Enough? Formulation of a Personalized HIV Risk Score for Pre-Exposure Prophylaxis Initiation (PubMed)

Are CDC Guidelines for Pre-Exposure Prophylaxis Specific Enough? Formulation of a Personalized HIV Risk Score for Pre-Exposure Prophylaxis Initiation Preexposure prophylaxis (PrEP) has emerged as a human immunodeficiency virus (HIV) prevention tool for populations at highest risk for HIV infection. Current US Centers for Disease Control and Prevention (CDC) guidelines for identifying PrEP candidates may not be specific enough to identify gay, bisexual, and other men who have sex with men (MSM (...) ) at the highest risk for HIV infection. We created an HIV risk score for HIV-negative MSM based on Syndemics Theory to develop a more targeted criterion for assessing PrEP candidacy.Behavioral risk assessment and HIV testing data were analyzed for HIV-negative MSM attending the Los Angeles LGBT Center between January 2009 and June 2014 (n = 9481). Syndemics Theory informed the selection of variables for a multivariable Cox proportional hazards model. Estimated coefficients were summed to create an HIV risk

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2017 Sexually transmitted diseases

53. Population Pharmacokinetics of Doravirine and Exposure-Response in Individuals with HIV-1. (PubMed)

Population Pharmacokinetics of Doravirine and Exposure-Response in Individuals with HIV-1. Doravirine is a novel non-nucleoside reverse transcriptase inhibitor for the treatment of human immunodeficiency virus 1 (HIV-1). A population pharmacokinetic (PK) model was developed for doravirine using pooled data from densely sampled Phase 1 trials and from sparsely sampled Phase 2b and Phase 3 trials evaluating doravirine administered orally as a single entity or as part of a fixed-dose combination (...) of doravirine/lamivudine/tenofovir disoproxil fumarate. A one-compartment model with linear clearance from the central compartment adequately described the clinical PK of doravirine. While weight, age, and healthy versus HIV-1 status were identified as statistically significant covariates affecting doravirine PK, the magnitude of their effects was not clinically meaningful. Other intrinsic factors (gender, body mass index, race, ethnicity, and renal function) did not have statistically significant

2019 Antimicrobial Agents and Chemotherapy

54. Access to HIV Pre-exposure Prophylaxis in Practice Settings: a Qualitative Study of Sexual and Gender Minority Adults' Perspectives. (PubMed)

Access to HIV Pre-exposure Prophylaxis in Practice Settings: a Qualitative Study of Sexual and Gender Minority Adults' Perspectives. Sexual and gender minority (SGM) populations remain at disproportionate risk of HIV infection. Despite the effectiveness of pre-exposure prophylaxis (PrEP) in preventing HIV, PrEP uptake has been slow.To identify barriers and facilitators of PrEP access by examining SGM patients' experiences with accessing health care systems and engaging with providers about PrEP (...) made several suggestions to improve PrEP access including improving provider engagement with SGM patients, encouraging providers to initiate conversations about PrEP, and increasing awareness of medication financial support.In order to reduce HIV disparities, improving PrEP access will require additional efforts by providers and resources across health care settings to reduce barriers. Interventions to improve provider education about PrEP and provider communication skills for discussing sexual

2019 Journal of General Internal Medicine

55. Tenofovir DF/emtricitabine/rilpivirine as HIV post-exposure prophylaxis: results from a multicentre prospective study. (PubMed)

Tenofovir DF/emtricitabine/rilpivirine as HIV post-exposure prophylaxis: results from a multicentre prospective study. Since 2016, French guidelines have recommended the single-tablet regimen of tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC)/rilpivirine (RPV) as HIV post-exposure prophylaxis (PEP), but few data support this usage. We evaluated the tolerability, treatment completion and occurrence of HIV seroconversion associated with this combination in occupational and non (...) -occupational PEP.We conducted an observational, prospective, multicentre, open-label, non-randomized study in five French HIV centres. Adults requiring PEP according to national French guidelines were prescribed TDF/FTC/RPV one pill once a day for 28 days. Clinical and biological tolerability was assessed at week 4; occurrence of HIV seroconversion was evaluated after week 16.From March 2016 to March 2017, 163 courses of PEP were prescribed for 150 sexual exposures (44% heterosexual and 56% MSM) and 13 non

2019 Journal of Antimicrobial Chemotherapy

56. US Guideline Criteria for HIV Pre-Exposure Prophylaxis: Clinical Considerations and Caveats. (PubMed)

US Guideline Criteria for HIV Pre-Exposure Prophylaxis: Clinical Considerations and Caveats. Clinical guidelines for HIV pre-exposure prophylaxis (PrEP) developed by the US Centers for Disease Control and Prevention have been instrumental to the implementation of PrEP in medical practices throughout the country. However, the eligibility criteria contained within may inadvertently limit PrEP access for some patients. We describe key considerations and caveats surrounding these criteria: (1 (...) ) promotion of a selective vs. universal approach to sexual health education involving PrEP; (2) misalignment between criteria stated in the table and text boxes; (3) problematic categorization and confounding of sexual orientation, gender identity, and risk behavior; (4) underemphasis of network/community-level drivers of HIV transmission; (5) oversimplification of serodiscordant risk; and (6) lack of clarity surrounding the relevance of condoms to PrEP eligibility. We offer concrete recommendations

2019 Clinical Infectious Diseases

57. Race/Ethnicity and Protease Inhibitor Use Influence Plasma Tenofovir Exposure in Adults Living with HIV-1 in AIDS Clinical Trials Group Study A5202. (PubMed)

Race/Ethnicity and Protease Inhibitor Use Influence Plasma Tenofovir Exposure in Adults Living with HIV-1 in AIDS Clinical Trials Group Study A5202. Introduction AIDS Clinical Trial Group A5202 (ClinicalTrials.gov identifier NCT00118898) was a phase 3b, randomized, partially blinded equivalence study of open-label atazanavir/ritonavir or efavirenz, plus either placebo-controlled tenofovir disoproxil fumarate/emtricitabine, or abacavir/lamivudine in treatment-naïve adults living with HIV-1 (...) and peripheral compartments = 127 and 646 L, and apparent inter-compartmental clearance = 107 L/h. In addition to race/ethnicity, creatinine clearance and assignment to atazanavir/r or efavirenz were significantly associated with CL/F (p < 0.001).Conclusion Race/ethnicity is associated with tenofovir oral CL in HIV-1 positive, treatment-naïve adults. This covariate relationship raises questions about the possibility of differences in efficacy and risk of adverse events in different patient populations

2019 Antimicrobial Agents and Chemotherapy

58. Systematic review of HIV treatment adherence research among people who inject drugs in the United States and Canada: evidence to inform pre-exposure prophylaxis (PrEP) adherence interventions. (PubMed)

Systematic review of HIV treatment adherence research among people who inject drugs in the United States and Canada: evidence to inform pre-exposure prophylaxis (PrEP) adherence interventions. People who inject drugs (PWID) are at increased risk for HIV acquisition and could benefit from antiretroviral pre-exposure prophylaxis (PrEP). However, PrEP has been underutilized in this population, and PrEP adherence intervention needs are understudied.To inform PrEP intervention development, we (...) reviewed evidence on antiretroviral therapy (ART) adherence among HIV-infected PWID. Guided by a behavioral model of healthcare utilization and using the PICOS framework, we conducted a systematic review in four electronic databases to identify original research studies of ART adherence in HIV-infected PWID in the United States and Canada between Jan 1, 2006-Dec 31, 2016. We synthesized and interpreted findings related to developing recommendations for PrEP adherence interventions for PWID.After

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2019 BMC Public Health

59. Effect of rectal douching/enema on rectal gonorrhoea and chlamydia among a cohort of men who have sex with men on HIV pre-exposure prophylaxis. (PubMed)

Effect of rectal douching/enema on rectal gonorrhoea and chlamydia among a cohort of men who have sex with men on HIV pre-exposure prophylaxis. Rectal douching/enema (RD) is a common practice among men who have sex with men (MSM) in preparation for sex. RD can break down the rectal mucosal barrier and potentially affect the rectal microbiome. The objective of this study was to understand if RD is associated with acquiring rectal infections (RI) with rectal gonorrhoea (NG) and/or chlamydia (CT (...) ).From 2013 to 2015, 395 adult HIV-uninfected MSM were enrolled in a randomised controlled study for pre-exposure prophylaxis (PrEP) adherence with routine sexual risk survey and testing. Using data from this cohort, baseline differences by RI were assessed using Pearson's χ² and Wilcoxon-Mann-Whitney test. Association between RD and RI was modelled using multivariable logistic regression adjusted for potential confounders (sexual behaviour, substance use and age) selected a priori. Effect

2019 Sexually transmitted infections

60. Understanding willingness to use oral pre-exposure prophylaxis for HIV prevention among men who have sex with men in China. (PubMed)

Understanding willingness to use oral pre-exposure prophylaxis for HIV prevention among men who have sex with men in China. Oral pre-exposure prophylaxis (PrEP) is recommended as an additional prevention choice for men who have sex with men (MSM) at substantial risk of HIV. The aim of this study was to evaluate the extent, and reasons, for MSM's willingness to use oral PrEP in Wuhan and Shanghai, China.Between May and December 2015, a cross-sectional survey was conducted among 487 MSM recruited (...) , and the possibility of taking PrEP only during particular periods of life when the risk of HIV exposure might be highest.

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2018 PLoS ONE

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