TY - JOUR
T1 - Incidence and Correlates of Sexually Transmitted Infections among Black Men Who Have Sex with Men Participating in the HIV Prevention Trials Network 073 Preexposure Prophylaxis Study
AU - Hightow-Weidman, Lisa B.
AU - Magnus, Manya
AU - Beauchamp, Geetha
AU - Hurt, Christopher B.
AU - Shoptaw, Steve
AU - Emel, Lynda
AU - Piwowar-Manning, Estelle
AU - Mayer, Kenneth H.
AU - Nelson, Laron E.
AU - Wilton, Leo
AU - Watkins, Phaedrea
AU - Whitfield, Darren
AU - Fields, Sheldon D.
AU - Wheeler, Darrell
N1 - Funding Information:
Acknowledgments. The authors thank the study team and participants at the following research sites: the University of North Carolina at Chapel Hill (CTU: AI069423-08/CTSA: 1UL1TR001111); the George Washington University, Milken Institute School of Public Health, Clinical Research Site (5UM1AI069053), and the District of Columbia Center for AIDS Research, a National Institutes of Health (NIH)–funded program (AI117970); and the University of California Los Angeles. The authors also acknowledge support from the HIV Prevention Trials Network (HPTN) Leadership and Operations Center, Family Health International 360; HPTN Laboratory Center Quality Assurance, Johns Hopkins University; HPTN Laboratory Center Pharmacology, Johns Hopkins University; HPTN Statistical and Data Management Center, Statistical Center for HIV/AIDS Research and Prevention; and Division of AIDS at the NIH; and Gilead Sciences, Inc.: Staci Bush, Lindsey Smith, James Rooney, and Brenda Ng. Other HPTN 073 contributors include Black Gay Research Group, HPTN Black Caucus, and District of Columbia Center for AIDS Research, an NIH-funded program (AI117970).
Funding Information:
Financial support. Overall support for the HPTN is provided by the NIAID of the NIH under award UM1AI068619 (HPTN Leadership and Operations Center), UM1AI068617 (HPTN Statistical and Data Management Center), and UM1AI068613 (HPTN Laboratory Center). Additional support was provided by the National Institute on Drug Abuse and the National Institute of Mental Health, of the NIH, US Department of Health and Human Services. The study product, tenofovir disoproxil fumarate/emtricitabine, was donated by Gilead Sciences, Inc.
Funding Information:
Potential conflicts of interest. L. N. has a patent on client-centered care coordination pending. C. B. H. has received grant support from Gilead Sciences. M. M. reports textbook royalties from Jones and Bartlett Learning Inc unrelated to the present work. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.
PY - 2019/10/15
Y1 - 2019/10/15
N2 - The HIV Prevention Trials Network (HPTN) Study 073 (HPTN 073) assessed the feasibility, acceptability, and safety of preexposure prophylaxis (PrEP) for black men who have sex with men (BMSM). The purpose of this analysis was to characterize the relationship between PrEP uptake and use and incident sexually transmitted infections (STIs) among participants enrolled in HPTN 073. Methods: A total of 226 human immunodeficiency virus (HIV)-uninfected BMSM were enrolled in 3 US cities; all participants received client-centered care coordination (C4) and were offered daily oral PrEP. Participants were followed for 12 months with STI testing (rectal and urine nucleic acid amplification test for gonorrhea and chlamydia, rapid plasma reagin for syphilis) conducted at baseline, week 26, and week 52. Logistic regression was used to examine associations between STI incidence and PrEP uptake. Generalized estimating equations were used to evaluate associations between age, PrEP acceptance, sexual behaviors, and incident STIs. Results: Baseline STI prevalence was 14.2%. Men aged <25 years were more likely to have a baseline STI (25.3% vs 6.7%; odds ratio [OR], 4.39; 95% confidence interval [CI:, 1.91, 10.11). Sixty participants (26.5%) acquired ≥1 STI during follow-up; the incidence rate was 34.2 cases per 100 person-years (95% CI, 27.4, 42.9). In adjusted analyses, baseline STI diagnosis (OR, 4.23; 95% CI, 1.82, 9.87; P <. 001) and additional C4 time (OR, 1.03; 95% CI, 1.00, 1.06; P =. 027) were associated with having an incident STI. STI incidence was not associated with PrEP acceptance or adherence. Conclusions: While we found higher rates of STIs in younger BMSM, overall rates of STI were lower than in prior PrEP trials, with no increase over time. BMSM with STIs at PrEP initiation may require additional interventions that target STI acquisition risk. Clinical Trials Registration: NCT01808352.
AB - The HIV Prevention Trials Network (HPTN) Study 073 (HPTN 073) assessed the feasibility, acceptability, and safety of preexposure prophylaxis (PrEP) for black men who have sex with men (BMSM). The purpose of this analysis was to characterize the relationship between PrEP uptake and use and incident sexually transmitted infections (STIs) among participants enrolled in HPTN 073. Methods: A total of 226 human immunodeficiency virus (HIV)-uninfected BMSM were enrolled in 3 US cities; all participants received client-centered care coordination (C4) and were offered daily oral PrEP. Participants were followed for 12 months with STI testing (rectal and urine nucleic acid amplification test for gonorrhea and chlamydia, rapid plasma reagin for syphilis) conducted at baseline, week 26, and week 52. Logistic regression was used to examine associations between STI incidence and PrEP uptake. Generalized estimating equations were used to evaluate associations between age, PrEP acceptance, sexual behaviors, and incident STIs. Results: Baseline STI prevalence was 14.2%. Men aged <25 years were more likely to have a baseline STI (25.3% vs 6.7%; odds ratio [OR], 4.39; 95% confidence interval [CI:, 1.91, 10.11). Sixty participants (26.5%) acquired ≥1 STI during follow-up; the incidence rate was 34.2 cases per 100 person-years (95% CI, 27.4, 42.9). In adjusted analyses, baseline STI diagnosis (OR, 4.23; 95% CI, 1.82, 9.87; P <. 001) and additional C4 time (OR, 1.03; 95% CI, 1.00, 1.06; P =. 027) were associated with having an incident STI. STI incidence was not associated with PrEP acceptance or adherence. Conclusions: While we found higher rates of STIs in younger BMSM, overall rates of STI were lower than in prior PrEP trials, with no increase over time. BMSM with STIs at PrEP initiation may require additional interventions that target STI acquisition risk. Clinical Trials Registration: NCT01808352.
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U2 - 10.1093/cid/ciy1141
DO - 10.1093/cid/ciy1141
M3 - Article
C2 - 30615169
AN - SCOPUS:85073183981
VL - 69
SP - 1597
EP - 1604
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
SN - 1058-4838
IS - 9
ER -