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Missed opportunities of HIV pre-exposure prophylaxis in France: a retrospective analysis in the French DAT’AIDS cohort

Title: Missed opportunities of HIV pre-exposure prophylaxis in France: a retrospective analysis in the French DAT’AIDS cohort
Authors: C. Lions; O. Cabras; L. Cotte; T. Huleux; A. Gagneux-Brugnon; A. Makinson; A. Cabié; B. Bonnet; C. Duvivier; L. Hocqueloux; E. Cua; A. Cheret; L. Hustache-Mathieu; V. Obry-Roguet; C. Jacomet; I. Poizot-Martin; the DAT’AIDS STUDY GROUP
Source: BMC Infectious Diseases, Vol 19, Iss 1, Pp 1-9 (2019)
Publisher Information: BMC
Publication Year: 2019
Collection: Directory of Open Access Journals: DOAJ Articles
Subject Terms: Pre-exposure prophylaxis; PrEP; HIV; Missed opportunities; HIV testing; Infectious and parasitic diseases; RC109-216
Description: Background HIV pre-exposure prophylaxis (PrEP) was implemented in France in November 2015 based on individual-level risk factors for HIV infection. We evaluated the proportion of missed opportunities for PrEP among newly HIV-diagnosed people entering the Dat’AIDS cohort in 2016. Methods Multicenter retrospective analysis in 15 French HIV clinical centers of patients with a new diagnosis of HIV infection. Among them we differentiated patients according to the estimated date of infection: those occurring in the PrEP area (a previous negative HIV test in the last 12 months or those with an incomplete HIV-1 western blot (WB) with no HIV-1 anti-Pol-antibody at time of HIV diagnosis) and those in the pre-PrEP area (older infections). Epidemiological, biological and clinical data at HIV diagnosis were collected. Clinicians retrospectively identified potential eligibility for PrEP based on individual-level risk factors for HIV infection among those infected in the PrEP area. Results Among 966 patients with a new HIV diagnosis, 225 (23.3%) were infected in the PrEP area and 121 (53.8%) had complete data allowing evaluation of PrEP eligibility. Among them, 110 (91%) would have been eligible for PrEP, median age 31 years, with 68 (75.6%) born in France and 10 (11.1%) in Central/West Africa, with more than one previous STI in 19 (15.7%). The main eligibility criteria for PrEP were being a man who had sex with men or transgender 91 (82.7%) with at least one of the following criteria: unprotected anal sex with ≥2 partners in the last 6 months: 67 (60.9%); bacterial sexually transmitted infection in the last 12 months: 33 (30%); Use of psychoactive substances in a sexual context (chemsex): 16 (14.5%). PrEP was indicated for other HIV risk factors in 25 (22.7%). Conclusion With 91% (110/121) of patients infected in the PrEP area eligible for PrEP, this study highlights the high potential of PrEP in avoiding new infection in France but also shows a persistent delay in HIV testing. Thus, an important limit on PrEP ...
Document Type: article in journal/newspaper
Language: English
Relation: http://link.springer.com/article/10.1186/s12879-019-3915-5; https://doaj.org/toc/1471-2334; https://doaj.org/article/af507039590a46c4a343ce553fdf20c4
DOI: 10.1186/s12879-019-3915-5
Availability: https://doi.org/10.1186/s12879-019-3915-5; https://doaj.org/article/af507039590a46c4a343ce553fdf20c4
Accession Number: edsbas.A8D76128
Database: BASE