Directors' Choice


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Feb.  2019 Hoenigl M, Jain S, Moore D, Collins D, Sun X, Anderson PL, Corado K, Blumenthal JS, Daar ES, Milam J, Dube MP, Morris S, California Collaborative Treatment Group 595 Team. Substance use and adherence to HIV preexposure prophylaxis for men who have sex with men. Emerg Infect Dis. 2018;24(12). PMID: 30457536. PMCID: 6256399.

About This Paper:

The effectiveness of oral HIV preexposure prophylaxis (PrEP) strongly depends on maintaining adherence. This study investigated the association between substance use and PrEP adherence, as well as incident sexually transmitted infections (STIs) in a high-risk cohort of 394 participants (391 men who have sex with men and 3 transgender women) who were enrolled in a PrEP demonstration project. Investigators assessed baseline and ongoing substance use over a 48-week period for stimulants and nonstimulant substances and for each substance separately. They also measured PrEP adherence by using dried blood spots to obtain levels of tenofovir diphosphate. No differences in these levels were found between substance users and nonsubstance users. Further, baseline substance use was associated with higher likelihood of study completion. Baseline stimulant use was strongly associated (odds ratio 3.4; p<0.001) with incident STIs during the study. Thus, PrEP adherence was not decreased by substance use. Because substance users had increased rates of STIs, indicating higher-risk behavior, they might be excellent candidates for PrEP.”

View other Directors' Choice selections from 20192018,  2017, and  2016.

At a Glance