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HIV pre-exposure prophylaxis initiation behaviour during the Covid-19 pandemic

Live Presentation

Speak with Maximilian Schaefer about his practicum on January 31st from 3:45-4:15pm via this .

Video Presentation

View Maximilian Schaefer's poster presentation in this video recording: 

Abstract

Background: The Covid-19 pandemic has affected people’s lives all over the world. This includes influencing medical services and care. HIV/AIDS remains a relevant epidemic, especially in high-risk populations. Reducing HIV transmission is an important step on the road to HIV/AIDS elimination. Social distancing rules during the Covid-19 pandemic led to decreased pre-exposure prophylaxis (PrEP) use and decreased casual sexual activities during lockdown periods, however this was not reduced to zero. This project aimed to report on the uptake of PrEP during the Covid-19 pandemic and describe characteristics of the individuals who solicited for PrEP, who started PrEP, and how patients’ profiles differed between dosing strategies. 

Methods & Analyses: Clinique L’Actuel, a large sexual health clinic in Montreal, Canada, hosts a prospective dynamic cohort of 3,000 persons who use PrEP. This cohort was initiated in 2013. Data collection is integrated into the PrEP care provided at L’Actuel and done through questionnaires (partially self-administered by patients and partially completed by medical staff). Data were collected between March 2020 and June 2021. Three descriptive analyses of the data were conducted: one overall profile of participants in the cohort, and two analyses with regards to two sets of specific outcomes, namely of patients soliciting PrEP, (1) whether they initiated PrEP, and (2) what dosing strategy was chosen. 

Results & Discussion: Out of 201 patients included in the PrEP initiation analysis, 65.2% (n = 131) started PrEP. Both outcome groups were similar in age, and sexual identity. 259 of patients were included in the dosing strategy analysis, of which 74% were prescribed daily PrEP (n = 192), and 25% on-demand (n = 67), and 1% refused (n = 2). Patients with on-demand strategy were slightly older (median 36 years vs. 34 years for daily PrEP). Based on these analyses, lifetime history of sexually transmitted infections (STIs), sexual behaviour and drug use during sex in the 12 months prior to initial PrEP appointment appeared to influence both actual PrEP uptake, and dosing strategy. Health care professionals may want to consider patients’ backgrounds regarding these factors when evaluating and supporting patients interested in PrEP as a prevention strategy. Further research is needed. 

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