Eligibility for PrEP among members of a HIV-negative MSM Portuguese Cohort

INTRODUCTION:   Pre-exposure prophylaxis (PrEP) is an effective prevention option for people at high risk for HIV infection. We aimed to characterize and estimate candidates to PrEP using a cohort of HIV-negative MSM.

METHODS:   We studied an ongoing dynamic cohort of HIV-negative MSM who present for testing at a peer-based voluntary counseling and testing center in Lisbon, Portugal (CheckpointLX). Men testing negative are invited to follow-ups scheduled according to their convenience. Evaluations comprise rapid HIV testing and a behavioural questionnaire. Between April 2011 and May 2013, 1593 individuals were enrolled. Eligibility for PrEP was considered one or more of the New York State Department of Health AIDS Institute criteria were met. Differences in socio-demographic characteristics according with PrEP eligibility were calculated using the Chi-square test.

RESULTS:   At entry 693 (43.5%) reported unprotected anal intercourse, 2 (0.1%) were male-to-female transgender engaging in high-risk behaviours, 215 (13.5%) were in a serodiscordant couple, 45 (2.8%) engaged in transactional sex, 252 (15.8%) used stimulant drugs, 6 (0.4%) had more than one STI the previous year and 27 (1.7%) were prescribed  post-exposure prophylaxis  with high-risk behaviours. Overall, 950 (59.3%) participants were eligible for PrEP. They reported more frequently gay identity (85.9% vs. 82.0%), migrant status (26.9% vs. 22.4%), lower education (4.3% v. 2.2%) and had a HIV test (86.0% v. 79.8%).

CONCLUSIONS:   More than half of these HIV-negative MSM were eligible and could probably benefit from PrEP making urgent to understand feasibility of PrEP implementation to support policies aiming to scale-up its use.