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Correlates of nonadherence to key population-led HIV pre-exposure prophylaxis services among Thai men who have sex with men and transgender women
BACKGROUND: Based on government estimates from the Asian Epidemic Model, new infections among men who have sex with men (MSM) and transgender women (TGW) in Thailand are forecast to proportionally increase over time. Daily oral Pre-exposure prophylaxis (PrEP) protects against HIV acquisition when us...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6429797/ https://www.ncbi.nlm.nih.gov/pubmed/30898095 http://dx.doi.org/10.1186/s12889-019-6645-0 |
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author | Seekaew, Pich Nguyen, Ezie Sungsing, Thanthip Jantarapakde, Jureeporn Pengnonyang, Supabhorn Trachunthong, Deondara Mingkwanrungruang, Pravit Sirisakyot, Waraporn Phiayura, Pattareeya Panpet, Phubet Meekrua, Phathranis Praweprai, Nanthika Suwan, Fonthip Sangtong, Supakarn Brutrat, Pornpichit Wongsri, Tashada Nakorn, Panus Rattakittvijun Na Mills, Stephen Avery, Matthew Vannakit, Ravipa Phanuphak, Praphan Phanuphak, Nittaya |
author_facet | Seekaew, Pich Nguyen, Ezie Sungsing, Thanthip Jantarapakde, Jureeporn Pengnonyang, Supabhorn Trachunthong, Deondara Mingkwanrungruang, Pravit Sirisakyot, Waraporn Phiayura, Pattareeya Panpet, Phubet Meekrua, Phathranis Praweprai, Nanthika Suwan, Fonthip Sangtong, Supakarn Brutrat, Pornpichit Wongsri, Tashada Nakorn, Panus Rattakittvijun Na Mills, Stephen Avery, Matthew Vannakit, Ravipa Phanuphak, Praphan Phanuphak, Nittaya |
author_sort | Seekaew, Pich |
collection | PubMed |
description | BACKGROUND: Based on government estimates from the Asian Epidemic Model, new infections among men who have sex with men (MSM) and transgender women (TGW) in Thailand are forecast to proportionally increase over time. Daily oral Pre-exposure prophylaxis (PrEP) protects against HIV acquisition when used as prescribed. The “Princess PrEP” program is the first key population-led (PrEP) initiative under Thai royal patronage with an aim to scale up countrywide implementation of PrEP. METHODS: Retention in and adherence to key population-led HIV PrEP services among HIV-uninfected Thai MSM and TGW was examined in four provinces: Bangkok, Chonburi, Chiang Mai, and Songkhla. HIV, HBsAg, creatinine tests, and self-administered questionnaires were performed during baseline measures. Participants were followed up after month 1, at month 3, then every 3 months. Correlates of nonadherence and loss to follow up at 1 month were assessed using linear regression models. RESULTS: 37.4% of the participants reported low adherence to services (≤ 3 pills/week or missed clinic schedule at month 1). Factors associated with low adherence included younger age (25 years and under) (adjusted odds ratio (aOR): 1.49, 95% confidence interval (95% CI: 1.01–2.21, p = 0.044), being a TGW (aOR: 2.2, 95% CI: 1.27–3.83, p = 0.005), and whether the participant had not previously accessed services at the clinic (aOR = 1.68, 95% CI: 1.03–2.76, p = 0.04). Additionally, participants in Chonburi (the only TGW site) showed significantly lower adherence than those in the other three provinces (aOR: 2.91, 95% CI: 1.55–5.45, p = 0.001). CONCLUSION: Urgent, innovative interventions for early PrEP adherence support among vulnerable sub-populations such as younger users, TGW, and new clients are needed to maximize prevention strategy in Thailand. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12889-019-6645-0) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6429797 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-64297972019-04-04 Correlates of nonadherence to key population-led HIV pre-exposure prophylaxis services among Thai men who have sex with men and transgender women Seekaew, Pich Nguyen, Ezie Sungsing, Thanthip Jantarapakde, Jureeporn Pengnonyang, Supabhorn Trachunthong, Deondara Mingkwanrungruang, Pravit Sirisakyot, Waraporn Phiayura, Pattareeya Panpet, Phubet Meekrua, Phathranis Praweprai, Nanthika Suwan, Fonthip Sangtong, Supakarn Brutrat, Pornpichit Wongsri, Tashada Nakorn, Panus Rattakittvijun Na Mills, Stephen Avery, Matthew Vannakit, Ravipa Phanuphak, Praphan Phanuphak, Nittaya BMC Public Health Research Article BACKGROUND: Based on government estimates from the Asian Epidemic Model, new infections among men who have sex with men (MSM) and transgender women (TGW) in Thailand are forecast to proportionally increase over time. Daily oral Pre-exposure prophylaxis (PrEP) protects against HIV acquisition when used as prescribed. The “Princess PrEP” program is the first key population-led (PrEP) initiative under Thai royal patronage with an aim to scale up countrywide implementation of PrEP. METHODS: Retention in and adherence to key population-led HIV PrEP services among HIV-uninfected Thai MSM and TGW was examined in four provinces: Bangkok, Chonburi, Chiang Mai, and Songkhla. HIV, HBsAg, creatinine tests, and self-administered questionnaires were performed during baseline measures. Participants were followed up after month 1, at month 3, then every 3 months. Correlates of nonadherence and loss to follow up at 1 month were assessed using linear regression models. RESULTS: 37.4% of the participants reported low adherence to services (≤ 3 pills/week or missed clinic schedule at month 1). Factors associated with low adherence included younger age (25 years and under) (adjusted odds ratio (aOR): 1.49, 95% confidence interval (95% CI: 1.01–2.21, p = 0.044), being a TGW (aOR: 2.2, 95% CI: 1.27–3.83, p = 0.005), and whether the participant had not previously accessed services at the clinic (aOR = 1.68, 95% CI: 1.03–2.76, p = 0.04). Additionally, participants in Chonburi (the only TGW site) showed significantly lower adherence than those in the other three provinces (aOR: 2.91, 95% CI: 1.55–5.45, p = 0.001). CONCLUSION: Urgent, innovative interventions for early PrEP adherence support among vulnerable sub-populations such as younger users, TGW, and new clients are needed to maximize prevention strategy in Thailand. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12889-019-6645-0) contains supplementary material, which is available to authorized users. BioMed Central 2019-03-21 /pmc/articles/PMC6429797/ /pubmed/30898095 http://dx.doi.org/10.1186/s12889-019-6645-0 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Seekaew, Pich Nguyen, Ezie Sungsing, Thanthip Jantarapakde, Jureeporn Pengnonyang, Supabhorn Trachunthong, Deondara Mingkwanrungruang, Pravit Sirisakyot, Waraporn Phiayura, Pattareeya Panpet, Phubet Meekrua, Phathranis Praweprai, Nanthika Suwan, Fonthip Sangtong, Supakarn Brutrat, Pornpichit Wongsri, Tashada Nakorn, Panus Rattakittvijun Na Mills, Stephen Avery, Matthew Vannakit, Ravipa Phanuphak, Praphan Phanuphak, Nittaya Correlates of nonadherence to key population-led HIV pre-exposure prophylaxis services among Thai men who have sex with men and transgender women |
title | Correlates of nonadherence to key population-led HIV pre-exposure prophylaxis services among Thai men who have sex with men and transgender women |
title_full | Correlates of nonadherence to key population-led HIV pre-exposure prophylaxis services among Thai men who have sex with men and transgender women |
title_fullStr | Correlates of nonadherence to key population-led HIV pre-exposure prophylaxis services among Thai men who have sex with men and transgender women |
title_full_unstemmed | Correlates of nonadherence to key population-led HIV pre-exposure prophylaxis services among Thai men who have sex with men and transgender women |
title_short | Correlates of nonadherence to key population-led HIV pre-exposure prophylaxis services among Thai men who have sex with men and transgender women |
title_sort | correlates of nonadherence to key population-led hiv pre-exposure prophylaxis services among thai men who have sex with men and transgender women |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6429797/ https://www.ncbi.nlm.nih.gov/pubmed/30898095 http://dx.doi.org/10.1186/s12889-019-6645-0 |
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