@article{fdi:010082314,
  title = {{HIV} pre-exposure prophylaxis for men who have sex with men in west {A}frica : a multicountry demonstration study},
  author = {{L}aurent, {C}hristian and {K}eita, {B}. {D}. and {Y}aya, {I}ssifou and {L}e {G}uicher, {G}. and {S}agaon {T}eyssier, {L}uis and {A}gboyibor, {M}. {K}. and {C}oulibaly, {A}. and {T}raore, {I}. and {M}alan, {J}. {B}. and {D}e {B}aetselier, {I}. and {E}ubanks, {A}. and {R}iegel, {L}. and {C}astro, {D}. {R}. and {F}aye-{K}ette, {H}. and {K}one, {A}. and {D}iande, {S}. and {D}agnra, {C}. {A}. and {S}errano, {L}aetitia and {D}iallo, {F}. and {M}ensah, {E}. and {D}ah, {T}. {T}. {E}. and {A}noma, {C}. and {V}uylsteke, {B}. and {S}pire, {B}. and {C}oh{MSM}-{P}r{EP} {S}tudy {G}roup},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {HIV} pre-exposure prophylaxis ({P}r{EP}) data in men who have sex with men ({MSM}) in west {A}frica are essential to guide its large-scale implementation. {W}e assessed the uptake of event-driven and daily {P}r{EP}, {HIV} incidence, and changes over time in sexual behaviours and prevalence of bacterial sexually transmitted infections ({STI}s) in {MSM} in {B}urkina {F}aso, {C}ote d'{I}voire, {M}ali, and {T}ogo. {M}ethods {W}e did a prospective cohort study from {N}ov 20, 2017, to {A}pril 14, 2020, in four community-based clinics in {A}bidjan ({C}ote d'{I}voire), {B}amako ({M}ali), {L}ome ({T}ogo), and {O}uagadougou ({B}urkina {F}aso). {P}articipants were {MSM} aged 18 years or older at substantial risk of {HIV} infection. {P}articipants could choose between event-driven (2+1+1 dosing) and daily oral {P}r{EP} (tenofovir disoproxil fumarate 300 mg plus emtricitabine 200 mg), switch regimen, and discontinue or restart {P}r{EP}. {W}e compared {HIV} incidence in this study with that of the same cohort before the availability of {P}r{EP} ({C}oh{MSM}). {S}tatistical analysis included the {K}aplan-{M}eier method and mixed-effects regression models. {T}his study is registered with {C}linical{T}rials.gov, {NCT}03459157. {F}indings {W}e followed up 598 participants for a total of 743 center dot 6 person-years. {A}t enrolment, 445 (74%) of 598 participants chose event-driven {P}r{EP} and 153 (26%) of 598 chose daily {P}r{EP}. 60 (13%) of 445 and 65 (42%) of 153 partici pants switched {P}r{EP} regimen at least once (p<0 center dot 0001). 159 participants (27%) were lost to follow-up. {O}verall {HIV} incidence was 2 center dot 3 per 100 person-years (95% {CI} 1 center dot 3-3 center dot 7; adjusted incidence rate ratio 0 center dot 21, 95% {CI} 0 center dot 12-0 center dot 36 compared with {C}oh{MSM}). {A}dherence was optimal in 802 (41%) of 1946 measures with event-driven {P}r{EP} and in 394 (71%) of 554 measures with daily {P}r{EP} (p<0 center dot 0001). {C}overage of sex acts with {P}r{EP} only and {P}r{EP} and condom decreased during follow-up (p=0 center dot 039 if {P}r{EP} only; p=0 center dot 0025 if {P}r{EP} and condom). {T}he frequency of condomless anal sex remained stable (p=0 center dot 96). {T}he number of male sexual partners (p<0 center dot 0001) and number of sex acts with casual male partners (p=0 center dot 0014 for 1-4 sex acts in previous 4 weeks; p=0 center dot 030 for >= 5 sex acts) decreased. {T}he prevalence of gonorrhoea, chlamydia, and syphilis remained stable. {I}nterpretation {P}r{EP} availability helped prevent {HIV} infection and did not lead to an increase in risky sexual behaviours or other {STI}s. {P}r{EP} should be urgently implemented in west {A}frica. {R}etention in care and {P}r{EP} adherence require special attention to ensure {P}r{EP} reaches its full prevention potential. {F}unding {ANRS} and {E}xpertise {F}rance},
  keywords = {{AFRIQUE} {DE} {L}'{OUEST} ; {TOGO} ; {BURKINA} {FASO} ; {COTE} {D}'{IVOIRE} ; {MALI}},
  booktitle = {},
  journal = {{L}ancet {HIV}},
  volume = {8},
  numero = {7},
  pages = {{E}420--{E}428},
  ISSN = {2352-3018},
  year = {2021},
  DOI = {10.1016/s2352-3018(21)00005-9},
  URL = {https://www.documentation.ird.fr/hor/fdi:010082314},
}