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Post-exposure prophylaxis use and recurrent exposure to HIV among men who have sex with men who use crystal methamphetamine.

Abstract：

BACKGROUND:Men who have sex with men (MSM) who use crystal methamphetamine (CM) are at increased risk for HIV infection. Post-exposure prophylaxis (PEP) is a useful HIV prevention strategy if individuals are able to identify high-risk exposures and seek timely care, however to date there has been limited data on the use of PEP by CM users. METHODS A:Retrospective cohort study of all PEP prescriptions (N=1130 prescriptions among 788 MSM) at Fenway Community Health in Boston, MA was undertaken. Multivariable models were used to assess the association between CM use during exposure (7.4% used CM during exposure) and chronically (7.4% of MSM were chronic CM users) and individual-level and event-level outcomes among MSM who used PEP at least once. RESULTS:Compared to those who had not used CM, MSM PEP users who used CM more frequently returned for repeat PEP (aOR 5.13, 95% CI 2.82 to 9.34) and were significantly more likely to seroconvert over the follow-up period (aHR 3.61, 95% CI 1.51 to 8.60). MSM who used CM had increased odds of unprotected anal intercourse as the source of exposure (aOR 2.12, 95% CI 1.16 to 3.87) and knowing that their partner was HIV infected (aOR 2.27, 95% CI 1.42 to 3.64). CONCLUSIONS:While MSM who use CM may have challenges accessing ART in general, these data highlight the fact that those who were able to access PEP subsequently remained at increased risk of HIV seroconversion. Counseling and/or substance use interventions during the PEP course should be considered for CM-using MSM.

journal_name

Drug Alcohol Depend

journal_title

Drug and alcohol dependence

authors

Oldenburg CE,Jain S,Mayer KH,Mimiaga MJ

doi

10.1016/j.drugalcdep.2014.11.010

subject

Has Abstract

pub_date

2015-01-01 00:00:00

pages

75-80

eissn

0376-8716

issn

1879-0046

pii

S0376-8716(14)01922-X

journal_volume

146

pub_type

杂志文章

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