Clinical Edge

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Daily vs Nondaily Oral PrEP in At-Risk Groups

Clin Infect Dis; ePub 2018 Feb 6; Grant, et al

Daily oral preexposure prophylaxis (PrEP) dosing in men and transgender women who have sex with men increased coverage and protective drug concentrations in a cohort of patients in Harlem, while daily and nondaily regimens led to comparably favorable outcomes in Bangkok, according to an analysis of the Human Immunodeficiency Virus Prevention Trials Network O67/ADAPT study. At-risk men and transgender women who have sex with men were randomly assigned to 1 of 3 dosing regimens: 1 tablet daily, 1 tablet twice weekly with a postsex dose, or 1 tablet before and after sex. Researchers found:

  • 357 participants were randomized from July 2012 to May 2014.
  • In Bangkok, the coverage of sex events was 85% for the daily arm compared with 84% for the time-driven arm and 74% for the event-driven arm.
  • In Harlem, coverage was 66%, 47%, and 52% for these groups.
  • In Bangkok, PrEP medication concentrations in blood were consistent with use of ≥2 tablets per week in >95% of visits when sex was reported in the prior week.
  • In Harlem, medications concentrations occurred in 48.5% in the daily arm, 30.9% in the time-driven arm, and 16.7% in the event-driven arm.

Citation:

Grant RM, Mannheimer S, Hughes JP, et al. Daily and nondaily preexposure prophylaxis in men and transgender women who have sex with men: The Human Immunodeficiency Virus Prevention Trials Network 067/ADAPT study. [Published online ahead of print February 6, 2018]. Clin Infect Dis. doi:10.1093/cid/cix1086.

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