Preferences for Daily or Intermittent Pre-exposure Prophylaxis Regimens and Ability to Anticipate Sex Among HIV Uninfected Members of Kenyan HIV Serodiscordant Couples

Intermittent dosing for pre-exposure prophylaxis (PrEP) has been proposed as an alternative to daily PrEP to reduce cost and patient drug exposure and to improve adherence. One possible dosing regimen is pre-intercourse PrEP, which requires anticipating sex in advance. We examined preferences for da...

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Bibliographic Details
Published in:AIDS and behavior 2014-09, Vol.18 (9), p.1701-1711
Main Authors: Roberts, Sarah T., Heffron, Renee, Ngure, Kenneth, Celum, Connie, Kurth, Ann, Curran, Kathryn, Mugo, Nelly, Baeten, Jared M.
Format: Article
Language:English
Subjects:
Acquired Immune Deficiency Syndrome
Adult
Anti-HIV Agents - administration & dosage
Anti-HIV Agents - therapeutic use
Coitus
Couples
Family Characteristics
Female
Health Psychology
Health Surveys
Heterosexuality
HIV
HIV Infections - prevention & control
HIV Seronegativity
HIV Seropositivity - drug therapy
Homosexuality, Male - psychology
Human immunodeficiency virus
Humans
Infectious Diseases
Kenya
Knowledge
Male
Medical Research
Medicine
Medicine & Public Health
Original Paper
Patients
Pre-Exposure Prophylaxis - methods
Preventive medicine
Prophylaxis
Public Health
Sexual behavior
Sexually transmitted diseases
STD
Time Factors
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Summary:Intermittent dosing for pre-exposure prophylaxis (PrEP) has been proposed as an alternative to daily PrEP to reduce cost and patient drug exposure and to improve adherence. One possible dosing regimen is pre-intercourse PrEP, which requires anticipating sex in advance. We examined preferences for daily versus pre-intercourse PrEP and ability to anticipate sex among 310 HIV uninfected members of HIV serodiscordant heterosexual couples in Thika, Kenya, with high HIV knowledge and experience with daily PrEP use in a clinical trial setting. Preferences were evenly split between daily PrEP (47.4 %) and pre-intercourse PrEP (50.7 %). Participants were more likely to prefer daily PrEP if they reported unprotected sex during the prior month (adjusted prevalence ratio [aPR] 1.48, 95 % CI 1.20–1.81) or 3 h in advance, with younger participants being less likely to do so (aPR 0.43, 95 % CI 0.23–0.83 for ages 18–29 vs. ≥40). Findings suggest that intermittent PrEP could be a popular option in this population, but that optimal adherence and sufficient drug levels might be challenging with a pre-intercourse regimen.
ISSN:1090-7165
1573-3254
DOI:10.1007/s10461-014-0804-1