Use of strict behavioural eligibility criteria helps to identify a group of high-HIV risk gay men for participation in the NSW pre-exposure prophylaxis (PrEP) trial

Stream: Critical Perspectives on Pre-Exposure Prophylaxis (PReP)
Date: Friday, 1 April 2016
Time: 2.00 pm – 3.45 pm

Abstract

Introduction: Australian criteria for determining behavioural eligibility for HIV pre-exposure prophylaxis (PrEP) are unique. These eligibility criteria have been first trialled in the PrELUDE study. We assessed the characteristics and risk profile of study participants to evaluate how these behavioural risk criteria performed.

Methods: Data on behavioural eligibility from the pre-screening forms of 303 PrELUDE participants was analysed using STATA to assess the effectiveness of the Australian behavioural eligibility criteria in identifying patients at high-risk of HIV.

Results: PrELUDE participants had a median age of 36 years (range: 20-69 years) and most identified as gay or bisexual men (GBM, 97.4%). The majority (83%) were full or part-time employed, 81% had attained post-secondary education and 49% were circumcised. Approximately 85% of participants met at least one high-risk criterion, with 48% meeting two or more high-risk criteria. Having had any receptive intercourse with a casual male partner of HIV-positive or unknown status, or using methamphetamines in the previous 3 months individually accounted for 80% and 44% of high-risk enrolments, respectively. Participants identified as medium-risk were predominately GBM offered PrEP based on the prescriber’s clinical judgement, or women planning to conceive naturally with an HIV-positive partner.

Conclusions: Newly developed Australian behavioural eligibility criteria successfully select individuals who are at the highest risk of HIV acquisition, whilst allowing patients with more complex needs the opportunity to access PrEP on a case-by-case basis. Such criteria enable the precise targeting of PrEP to individuals who can benefit most.

Authors

Stefanie Vaccher (Presenter), The Kirby Institute
Stefanie is a PhD candidate at the Kirby Institute, investigating adherence of high-risk individuals to HIV pre-exposure prophylaxis (PrEP). She is also responsible for monitoring the behavioural data obtained as part of the PrELUDE Study, which is Australia's largest PrEP demonstration project.

Andrew Grulich, The Kirby Institute

Garrett Prestage, The Kirby Institute; Australian Research Centre in Sex Health and Society

Iryna Zablotska, The Kirby Institute