%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Sagaon Teyssier, Luis
%A Mabire, X.
%A Laguette, V.
%A Fressard, L.
%A Suzan-Monti, M.
%A Rojas Castro, D.
%A Hall, N.
%A Capitant, C.
%A Meyer, L.
%A Chidiac, C.
%A Tremblay, C.
%A Preau, M.
%A Spire, B.
%A Molina, J. M.
%A ANRS IPERGAY Study Group
%T A group-based trajectory model for changes in pre-exposure prophylaxis and condom use among men who have sex with men participating in the ANRS IPERGAY trial
%D 2018
%L fdi:010074931
%G ENG
%J Aids Patient Care and Stds
%@ 1087-2914
%K PrEP ; condoms ; MSM ; anal intercourse ; multi-trajectory modeling
%K FRANCE ; CANADA
%M ISI:000451812300003
%N 12
%P 495-510
%R 10.1089/apc.2018.0081
%U https://www.documentation.ird.fr/hor/fdi:010074931
%> https://www.documentation.ird.fr/intranet/publi/2019/02/010074931.pdf
%V 32
%W Horizon (IRD)
%X Pre-exposure prophylaxis (PrEP) is one of the most important milestones in HIV prevention for high-risk HIV-negative people. The introduction of PrEP into the HIV prevention package has raised the question of possible risk compensation, and in particular, a reduction in condom use. Although open-label extension (OLE) studies have enabled investigators to examine risk compensation in more real-life settings, results to date have been inconclusive regarding PrEP-induced behavioral changes. We aimed to identify behavioral trajectories over time for PrEP and condom use, and to investigate the link between these trajectories. Group-based trajectory modeling using logistic specification was implemented. Data of the 332 individuals participating in the double-blind and OLE phases of ANRS IPERGAY were used. Four distinct group trajectories were identified: 49.7% of the participants had "systematic adherence to PrEP," 19% had "high adherence to PrEP, 15.3% had "declining adherence to PrEP," and 16% had "low adherence to PrEP." Two condom trajectories were identified: 53% (n = 176) of the 332 participants were "low-level users" of condoms, and 47% were "high-level users." Among the former, 24.4% also belonged to the "low adherence to PrEP" group. This most-at-risk group represented 13% of all the participants. The effectiveness of offering sexual activity-based PrEP as part of the French HIV prevention package in the ANRS IPERGAY clinical trial is demonstrated by the relatively small proportion of participants that offset their low-level condom use with PrEP adherence. The results from this work may help in the future development of tailored prevention programs for high-risk HIV-negative people.
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