Details:

Alternative Title:
Open Forum Infect Dis
Personal Author:
Kung, Vanessa ; Pattanasin, Sarika ; Ungsedhapand, Chaiwat ; Wimonsate, Wipas ; Thigpen, Michael ; ... More +
Kung, Vanessa ; Pattanasin, Sarika ; Ungsedhapand, Chaiwat ; Wimonsate, Wipas ; Thigpen, Michael ; Dunne, Eileen Less -
Description:
Background

Since 2014, the Thailand National Guidelines have recommended pre-exposure prophylaxis (PrEP) to prevent HIV among persons at risk. In March 2016, Silom Community Clinic (SCC) began PrEP provision to men who have sex with men (MSM) and transgender women (TGW) in Bangkok, Thailand.

Methods

SCC staff routinely counseled MSM and TGW attending HIV voluntary counseling and testing about PrEP. If clients believed that they were at substantial risk of HIV and were interested in PrEP, they could receive PrEP after screening that included HIV and renal function testing. Eligible clients received a 30-day supply of daily oral tenofovir-emtricitabine costing 800 Baht (30 USD), and completed a baseline computer-assisted self-interview (CASI) on knowledge and behaviors. At every 3-month follow-up, PrEP clients had a CASI on adherence; if they were interested in discontinuation of PrEP, they completed a CASI that included reasons for discontinuation. We conducted a descriptive analysis of baseline and follow-up CASI results.

Results

From March 2016 to February 2018, 192 clients were prescribed PrEP, and 80 (42%) continued PrEP for at least 6 months. The median age of clients starting PrEP was 31 years (range, 17–67 years), and 98% were MSM. Overall, most (77%) reported at least 1 of four risk behaviors in the last 3 months; among the 148, 120 (81%) had a sex partner with unknown or positive HIV status, 99 (67%) had anal sex without a condom, 22 (15%) reported an STI, and 16 (11%) received money or goods in exchange for sex. Among the 166 clients who returned for at least one follow-up visit, 135 (81%) completed the CASI at the last follow-up visit; of those, 106 (78%) reported 100% adherence to daily PrEP in the last 7 days, and 126 (93%) reported ≥80% adherence in the last 30 days. Of the 36 clients who discontinued PrEP and completed CASI, 33% reported the reason for discontinuation was no current HIV risk (33%); most (69%) reported that they would consider PrEP in the future.

Conclusion

Most PrEP users reported adherence to daily PrEP, and almost one half of those starting PrEP continued through month six. PrEP use at SCC is dynamic, and commonly started and stopped based on self-assessed risk. Regular review of PrEP implementation, with a focus on client needs, will optimize use of this prevention approach.

Disclosures

All authors: No reported disclosures.


Subjects:
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Abstracts
Source:
Open Forum Infect Dis. 2018; 5(Suppl 1):S394-S395
Pubmed Central ID:
PMC6253080
Document Type:
Journal Article
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:2182259ed01dbbeaf9f088157e0e3af3bfab1d8909d6ad08a244b2ca46311b5f
Download URL:
https://stacks.cdc.gov/view/cdc/78023/cdc_78023_DS1.pdf
File Type:

Supporting Files

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