No Evidence of Sexual Risk Compensation in the iPrEx Trial of Daily Oral HIV Preexposure Prophylaxis
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{"title"=>"No Evidence of sexual risk compensation in the iPrEx trial of daily oral HIV preexposure prophylaxis", "type"=>"journal", "authors"=>[{"first_name"=>"Julia L.", "last_name"=>"Marcus", "scopus_author_id"=>"26028870700"}, {"first_name"=>"David V.", "last_name"=>"Glidden", "scopus_author_id"=>"7004401932"}, {"first_name"=>"Kenneth H.", "last_name"=>"Mayer", "scopus_author_id"=>"7201681809"}, {"first_name"=>"Albert Y.", "last_name"=>"Liu", "scopus_author_id"=>"37031463000"}, {"first_name"=>"Susan P.", "last_name"=>"Buchbinder", "scopus_author_id"=>"35391587900"}, {"first_name"=>"K. Rivet", "last_name"=>"Amico", "scopus_author_id"=>"9747334100"}, {"first_name"=>"Vanessa", "last_name"=>"McMahan", "scopus_author_id"=>"25641526600"}, {"first_name"=>"Esper Georges", "last_name"=>"Kallas", "scopus_author_id"=>"35499569700"}, {"first_name"=>"Orlando", "last_name"=>"Montoya-Herrera", "scopus_author_id"=>"37031624700"}, {"first_name"=>"Jose", "last_name"=>"Pilotto", "scopus_author_id"=>"6507907867"}, {"first_name"=>"Robert M.", "last_name"=>"Grant", "scopus_author_id"=>"7402006018"}], "year"=>2013, "source"=>"PLoS ONE", "identifiers"=>{"sgr"=>"84893174696", "doi"=>"10.1371/journal.pone.0081997", "pui"=>"372232253", "arxiv"=>"NIHMS150003", "issn"=>"19326203", "pmid"=>"24367497", "isbn"=>"1932-6203 (Electronic)\\n1932-6203 (Linking)", "scopus"=>"2-s2.0-84893174696"}, "id"=>"501aea60-f260-3c18-acda-c5bb2e62bc21", "abstract"=>"OBJECTIVE Preexposure prophylaxis (PrEP) with emtricitabine/tenofovir disoproxil fumarate (FTC/TDF) reduced HIV acquisition in the iPrEx trial among men who have sex with men and transgender women. Self-reported sexual risk behavior decreased overall, but may be affected by reporting bias. We evaluated potential risk compensation using biomarkers of sexual risk behavior. DESIGN AND METHODS Sexual practices were assessed at baseline and quarterly thereafter; perceived treatment assignment and PrEP efficacy beliefs were assessed at 12 weeks. Among participants with ≥1 follow-up behavioral assessment, sexual behavior, syphilis, and HIV infection were compared by perceived treatment assignment, actual treatment assignment, and perceived PrEP efficacy. RESULTS Overall, acute HIV infection and syphilis decreased during follow-up. Compared with participants believing they were receiving placebo, participants believing they were receiving FTC/TDF reported more receptive anal intercourse partners prior to initiating drug (12.8 vs. 7.7, P = 0.04). Belief in receiving FTC/TDF was not associated with an increase in receptive anal intercourse with no condom (ncRAI) from baseline through follow-up (risk ratio [RR] 0.9, 95% confidence interval [CI]: 0.6-1.4; P = 0.75), nor with a decrease after stopping study drug (RR 0.8, 95% CI: 0.5-1.3; P = 0.46). In the placebo arm, there were trends toward lower HIV incidence among participants believing they were receiving FTC/TDF (incidence rate ratio [IRR] 0.8, 95% CI: 0.4-1.8; P = 0.26) and also believing it was highly effective (IRR 0.5, 95% CI: 0.1-1.7; P = 0.12). CONCLUSIONS There was no evidence of sexual risk compensation in iPrEx. Participants believing they were receiving FTC/TDF had more partners prior to initiating drug, suggesting that risk behavior was not a consequence of PrEP use.", "link"=>"http://www.mendeley.com/research/evidence-sexual-risk-compensation-iprex-trial-daily-oral-hiv-preexposure-prophylaxis-3", "reader_count"=>50, "reader_count_by_academic_status"=>{"Unspecified"=>1, "Professor > Associate Professor"=>1, "Librarian"=>1, "Researcher"=>9, "Student > Doctoral Student"=>4, "Student > Ph. D. Student"=>6, "Student > Master"=>14, "Other"=>3, "Student > Bachelor"=>9, "Lecturer"=>2}, "reader_count_by_user_role"=>{"Unspecified"=>1, "Professor > Associate Professor"=>1, "Librarian"=>1, "Researcher"=>9, "Student > Doctoral Student"=>4, "Student > Ph. D. Student"=>6, "Student > Master"=>14, "Other"=>3, "Student > Bachelor"=>9, "Lecturer"=>2}, "reader_count_by_subject_area"=>{"Unspecified"=>2, "Nursing and Health Professions"=>2, "Medicine and Dentistry"=>25, "Agricultural and Biological Sciences"=>4, "Neuroscience"=>1, "Philosophy"=>1, "Psychology"=>4, "Social Sciences"=>9, "Economics, Econometrics and Finance"=>2}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>25}, "Neuroscience"=>{"Neuroscience"=>1}, "Social Sciences"=>{"Social Sciences"=>9}, "Psychology"=>{"Psychology"=>4}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>2}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>4}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>2}, "Unspecified"=>{"Unspecified"=>2}, "Philosophy"=>{"Philosophy"=>1}}, "reader_count_by_country"=>{"United States"=>2, "Brazil"=>1}, "group_count"=>4}

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