Preexposure prophylaxis for HIV infection integrated with municipal-and community-based sexual health services

Albert Y. Liu, Stephanie E. Cohen, Eric Vittinghoff, Peter L. Anderson, Susanne Doblecki-Lewis, Oliver Bacon, Wairimu Chege, Brian S. Postle, Tim Matheson, K. Rivet Amico, Teri Liegler, M. Keith Rawlings, Nikole Trainor, Robert Wilder Blue, Yannine Estrada, Megan E. Coleman, Gabriel Cardenas, Daniel J Feaster, Robert Grant, Susan S. PhilipRichard Elion, Susan Buchbinder, Michael A Kolber

Research output: Contribution to journalArticle

269 Scopus citations


Importance Several randomized clinical trials have demonstrated the efficacy of preexposure prophylaxis (PrEP) in preventing human immunodeficiency virus (HIV) acquisition. Little is known about adherence to the regimen, sexual practices, and overall effectiveness when PrEP is implemented in clinics that treat sexually transmitted infections (STIs) and community-based clinics serving men who have sex with men (MSM). Objective To assess PrEP adherence, sexual behaviors, and the incidence of STIs and HIV infection in a cohort of MSM and transgender women initiating PrEP in the United States. Design, Setting, and Participants Demonstration project conducted from October 1, 2012, through February 10, 2015 (last date of follow-up), among 557 MSM and transgender women in 2 STI clinics in San Francisco, California, and Miami, Florida, and a community health center inWashington, DC. Data were analyzed from December 18, 2014, through August 8, 2015. Interventions A combination of daily, oral tenofovir disoproxil fumarate and emtricitabine was provided free of charge for 48 weeks. All participants received HIV testing, brief client-centered counseling, and clinical monitoring. Main Outcomes and Measures Concentrations of tenofovir diphosphate in dried blood spot samples, self-reported numbers of anal sex partners and episodes of condomless receptive anal sex, and incidence of STI and HIV acquisition. Results Overall, 557 participants initiated PrEP, and 437 of these (78.5%) were retained through 48 weeks. Based on the findings from the 294 participants who underwent measurement of tenofovir diphosphate levels, 80.0%to 85.6%had protective levels (consistent with 4 doses/wk) at follow-up visits. African American participants (56.8%of visits; P =.003) and those from the Miami site (65.1%of visits; P

Original languageEnglish (US)
Pages (from-to)75-84
Number of pages10
JournalJAMA Internal Medicine
Issue number1
StatePublished - Jan 1 2016

ASJC Scopus subject areas

  • Internal Medicine

Fingerprint Dive into the research topics of 'Preexposure prophylaxis for HIV infection integrated with municipal-and community-based sexual health services'. Together they form a unique fingerprint.

  • Cite this

    Liu, A. Y., Cohen, S. E., Vittinghoff, E., Anderson, P. L., Doblecki-Lewis, S., Bacon, O., Chege, W., Postle, B. S., Matheson, T., Rivet Amico, K., Liegler, T., Keith Rawlings, M., Trainor, N., Blue, R. W., Estrada, Y., Coleman, M. E., Cardenas, G., Feaster, D. J., Grant, R., ... Kolber, M. A. (2016). Preexposure prophylaxis for HIV infection integrated with municipal-and community-based sexual health services. JAMA Internal Medicine, 176(1), 75-84.