Journal article
Uptake and challenges with daily oral pre-exposure prophylaxis among men who have sex with men and transgender women, suburban Yangon, Myanmar
- Abstract:
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Background: Pre-exposure prophylaxis (PrEP) is effective for human immunodeficiency virus (HIV) prevention in risk groups. We assessed PrEP uptake and 12-month retention among men who have sex with men (MSM) and transgender women (TGW) in Myanmar during the coronavirus disease 2019 pandemic and a political crisis.
Methods: Using prospectively collected data, we assessed the proportion of persons eligible, initiated and retained 12 months on PrEP. We calculated HIV and syphilis incidence among those initiated on PrEP. Predictors of compliance to scheduled visits were assessed with fractional logistic regression.
Results: Among 652 persons screened between July and December 2020, 85.3% were eligible and 38.8% initiated PrEP. The daily pill burden was the main reason (86.5%) for refusing PrEP. A history of HIV post-exposure prophylaxis (PEP) and having an HIV-positive partner not on anti-retroviral therapy (ART) was associated with PrEP uptake (p<0.05). The 12-month retention among those initiating PrEP was 43.0%. Age ≥25 y, a history of PEP and having an HIV-positive partner not on ART predicted better compliance with scheduled visits (p<0.05). HIV incidence among PrEP initiators was 3.1 per 100 person-years (95% confidence interval [CI] 1.3 to 7.4) and syphilis incidence was 17.6 per 100 person-years (95% CI 12.3 to 25.1).
Conclusions: A PrEP program for MSM and TGW in Myanmar was implemented successfully under difficult circumstances. Alternative strategies are needed addressing PrEP uptake and retention.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 549.5KB, Terms of use)
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- Publisher copy:
- 10.1093/inthealth/ihae025
Authors
+ Global Fund to Fight AIDS, Tuberculosis and Malaria
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- Funder identifier:
- https://ror.org/02gysew38
- Grant:
- 20864-005-01
- Publisher:
- Oxford University Press
- Journal:
- International Health More from this journal
- Volume:
- 17
- Issue:
- 1
- Pages:
- 23-32
- Place of publication:
- England
- Publication date:
- 2024-03-29
- Acceptance date:
- 2024-03-01
- DOI:
- EISSN:
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1876-3405
- ISSN:
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1876-3413
- Pmid:
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38551313
- Language:
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English
- Keywords:
- Pubs id:
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1987905
- Local pid:
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pubs:1987905
- Deposit date:
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2025-01-21
- ARK identifier:
Terms of use
- Copyright holder:
- Tun et al
- Copyright date:
- 2025
- Rights statement:
- © The Author(s) 2024. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
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