Pre-exposure prophylaxis for HIV-negative persons with partners living with HIV: uptake, use, and effectiveness in an open-label demonstration project in East Africa

• DOI: 10.12688/gatesopenres.12752.1
• Publication Date: 2017-11-06T05:20:09Z
• Authors: Renee Heffron; Kenneth Ngure; Josephine Odoyo; Nulu Bulya; Edna Tindimwebwa; Ting Hong; Lara Kidoguchi; Deborah Donnell; Nelly R. Mugo; Elizabeth A. Bukusi; Elly Katabira; Stephen Asiimwe; Jennifer Morton; Susan Morrison; Harald Haugen; Andrew Mujugira; Jessica E. Haberer; Norma C. Ware; Monique A. Wyatt; Mark A. Marzinke; Lisa M. Frenkel; Connie Celum; Jared M. Baeten
• Keywords: Serodiscordant; Emtricitabine; Pre-exposure prophylaxis

Introduction: Pre-exposure prophylaxis (PrEP) can provide high protection against HIV infection and is a recommended intervention for HIV-negative persons with substantial risk, such as individuals partner living HIV. Demonstration projects of PrEP have been conducted in diverse settings worldwide to illustrate practical examples how be delivered. Methods: We evaluated delivery partners within heterosexual serodiscordant couples an open-label demonstration project East Africa. The model integrated into treatment services, prioritizing prior during the first 6 months after initiated antiretroviral therapy (ART). measured adherence through medication event monitoring system (MEMS) bottle caps quantification tenofovir plasma among random sample participants. estimated infections prevented using counterfactual cohort simulated from placebo arm previous clinical trial. Results: enrolled 1,010 that were naïve ART PrEP. Ninety-seven percent (97%) PrEP, when was dispensed, objective measures suggest adherence: 71% participants took ≥80% expected doses, recorded via MEMS, 81% samples had detected. A total 4 incident observed (incidence rate=0.24 per 100 person-years), 95% reduction (95% CI 86-98%, p<0.0001) incidence, relative incidence population absence services. Conclusions: uptake rare this African whose known Delivery feasible should prioritized wide-scale implementation.