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Client-Centered Counseling-Based Resource Center Increased Uptake of HIV Pre-Exposure Prophylaxis (PrEP) in a Randomized Controlled Trial of Young Black Men who have Sex with Men

BACKGROUND: New US HIV infections are increasingly concentrated among young Black men who have sex with men (BMSM). Although oral PrEP is recommended by the CDC and WHO, uptake has been low among young BMSM. We evaluated the effect of a resource center offering a client-centered counseling approach...

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Autores principales: Desrosiers, Aimee, Zumer, Maria, Levy, Matt, Dright, Aurnell, Jallah, Nikardi, Kuo, Irene, Magnus, Manya, Siegel, Marc
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5631387/
http://dx.doi.org/10.1093/ofid/ofx163.1116
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author Desrosiers, Aimee
Zumer, Maria
Levy, Matt
Dright, Aurnell
Jallah, Nikardi
Kuo, Irene
Magnus, Manya
Siegel, Marc
author_facet Desrosiers, Aimee
Zumer, Maria
Levy, Matt
Dright, Aurnell
Jallah, Nikardi
Kuo, Irene
Magnus, Manya
Siegel, Marc
author_sort Desrosiers, Aimee
collection PubMed
description BACKGROUND: New US HIV infections are increasingly concentrated among young Black men who have sex with men (BMSM). Although oral PrEP is recommended by the CDC and WHO, uptake has been low among young BMSM. We evaluated the effect of a resource center offering a client-centered counseling approach to address the psychosocial, health care, and HIV prevention needs of young BMSM on the uptake of PrEP METHODS: BMSM aged 16–25 were randomized on a 1:1 basis to (1) standard of care PrEP referral or (2) standard of care PrEP referral + counseling-based PrEP resource center at enrollment with ongoing phone- and texting-based support. Subjects were asked to follow at 3 months. We evaluated the number of subjects who were started on PrEP in the community and the number of new sexually transmitted infections (STIs) over the course of the study RESULTS: 50 HIV- BMSM were enrolled. Median age was 22 years. 43 subjects had seen a doctor in the last 12 months but only 13 had discussed PrEP and only 1 subject had taken PrEP before. 80% of subjects reported unprotected anal sex in the 3 months prior to enrollment, 31% with a man who was HIV-positive or of unknown HIV status. 42 subjects completed the study, 22 in the intervention and 20 in the control arm. 21 subjects saw a medical profession over the study period, of whom 14 discussed PrEp. 6 subjects, all of whom were in the intervention arm, started PrEP and 4 were still taking PrEP at the end of the study (P = 0.012). At baseline 1 subject was diagnosed with syphilis, 4 with gonorrhea and 10 with Chlamydia. At the 3-month visit, 1 subject was diagnosed with syphilis, 5 with gonorrhea, and 5 with Chlamydia. 2 subjects, 1 in the intervention and 1 in the control arm, tested positive for HIV at the 3-month mark. Neither subject was taking PrEP. There was no difference in the incidence of new STIs between the 2 groups. Fewer subjects reported unprotected anal intercourse both over the study period compared with prior to the study (64% vs. 80%), as well as with men who were HIV-positive or of unknown HIV status (31% vs. 19%) CONCLUSION: The large number of STIs over the study period (34 STIs in 21 subjects) highlights that this population is at high risk for HIV acquisition and would greatly benefit from PrEP. Our study shows that a resource center is an effective intervention to increase the uptake of PrEP in this patient population DISCLOSURES: All authors: No reported disclosures.
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spelling pubmed-56313872017-11-07 Client-Centered Counseling-Based Resource Center Increased Uptake of HIV Pre-Exposure Prophylaxis (PrEP) in a Randomized Controlled Trial of Young Black Men who have Sex with Men Desrosiers, Aimee Zumer, Maria Levy, Matt Dright, Aurnell Jallah, Nikardi Kuo, Irene Magnus, Manya Siegel, Marc Open Forum Infect Dis Abstracts BACKGROUND: New US HIV infections are increasingly concentrated among young Black men who have sex with men (BMSM). Although oral PrEP is recommended by the CDC and WHO, uptake has been low among young BMSM. We evaluated the effect of a resource center offering a client-centered counseling approach to address the psychosocial, health care, and HIV prevention needs of young BMSM on the uptake of PrEP METHODS: BMSM aged 16–25 were randomized on a 1:1 basis to (1) standard of care PrEP referral or (2) standard of care PrEP referral + counseling-based PrEP resource center at enrollment with ongoing phone- and texting-based support. Subjects were asked to follow at 3 months. We evaluated the number of subjects who were started on PrEP in the community and the number of new sexually transmitted infections (STIs) over the course of the study RESULTS: 50 HIV- BMSM were enrolled. Median age was 22 years. 43 subjects had seen a doctor in the last 12 months but only 13 had discussed PrEP and only 1 subject had taken PrEP before. 80% of subjects reported unprotected anal sex in the 3 months prior to enrollment, 31% with a man who was HIV-positive or of unknown HIV status. 42 subjects completed the study, 22 in the intervention and 20 in the control arm. 21 subjects saw a medical profession over the study period, of whom 14 discussed PrEp. 6 subjects, all of whom were in the intervention arm, started PrEP and 4 were still taking PrEP at the end of the study (P = 0.012). At baseline 1 subject was diagnosed with syphilis, 4 with gonorrhea and 10 with Chlamydia. At the 3-month visit, 1 subject was diagnosed with syphilis, 5 with gonorrhea, and 5 with Chlamydia. 2 subjects, 1 in the intervention and 1 in the control arm, tested positive for HIV at the 3-month mark. Neither subject was taking PrEP. There was no difference in the incidence of new STIs between the 2 groups. Fewer subjects reported unprotected anal intercourse both over the study period compared with prior to the study (64% vs. 80%), as well as with men who were HIV-positive or of unknown HIV status (31% vs. 19%) CONCLUSION: The large number of STIs over the study period (34 STIs in 21 subjects) highlights that this population is at high risk for HIV acquisition and would greatly benefit from PrEP. Our study shows that a resource center is an effective intervention to increase the uptake of PrEP in this patient population DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2017-10-04 /pmc/articles/PMC5631387/ http://dx.doi.org/10.1093/ofid/ofx163.1116 Text en © The Author 2017. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Desrosiers, Aimee
Zumer, Maria
Levy, Matt
Dright, Aurnell
Jallah, Nikardi
Kuo, Irene
Magnus, Manya
Siegel, Marc
Client-Centered Counseling-Based Resource Center Increased Uptake of HIV Pre-Exposure Prophylaxis (PrEP) in a Randomized Controlled Trial of Young Black Men who have Sex with Men
title Client-Centered Counseling-Based Resource Center Increased Uptake of HIV Pre-Exposure Prophylaxis (PrEP) in a Randomized Controlled Trial of Young Black Men who have Sex with Men
title_full Client-Centered Counseling-Based Resource Center Increased Uptake of HIV Pre-Exposure Prophylaxis (PrEP) in a Randomized Controlled Trial of Young Black Men who have Sex with Men
title_fullStr Client-Centered Counseling-Based Resource Center Increased Uptake of HIV Pre-Exposure Prophylaxis (PrEP) in a Randomized Controlled Trial of Young Black Men who have Sex with Men
title_full_unstemmed Client-Centered Counseling-Based Resource Center Increased Uptake of HIV Pre-Exposure Prophylaxis (PrEP) in a Randomized Controlled Trial of Young Black Men who have Sex with Men
title_short Client-Centered Counseling-Based Resource Center Increased Uptake of HIV Pre-Exposure Prophylaxis (PrEP) in a Randomized Controlled Trial of Young Black Men who have Sex with Men
title_sort client-centered counseling-based resource center increased uptake of hiv pre-exposure prophylaxis (prep) in a randomized controlled trial of young black men who have sex with men
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5631387/
http://dx.doi.org/10.1093/ofid/ofx163.1116
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