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. 2020 Aug 7;7(8):ofaa329.
doi: 10.1093/ofid/ofaa329. eCollection 2020 Aug.

PrEP Nonadherence, White Coat Dosing, and HIV Risk Among a Cohort of MSM

Cheríe S Blair  1 , Matthew R Beymer  2 , Ryan M Kofron  3 , Robert K Bolan  4 , Wilbert C Jordan  5 , Richard H Haubrich  6 , Amy R Wohl  7 , Raphael J Landovitz  1   3
Affiliations

PrEP Nonadherence, White Coat Dosing, and HIV Risk Among a Cohort of MSM

Cheríe S Blair et al. Open Forum Infect Dis. .

Abstract

Among a cohort of men who have sex with men in a pre-exposure prophylaxis (PrEP) adherence trial, syphilis requiring treatment was associated with white coat dosing (increased PrEP adherence immediately preceding study visits) when compared with participants with optimal drug concentrations. The findings highlight the need for identifying and reducing barriers to PrEP adherence.

Keywords: MSM; PrEP adherence; pre-exposure prophylaxis; syphilis; white coat dosing.

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Figures

Figure 1.
Figure 1.
Frequency of HIV risk behaviors and syphilis requiring treatment with optimal, suboptimal, and white coat dosing concentrations at study visits among a cohort of men who have sex with men using PrEP (n = 1254). Syphilis was screened at each study visit and defined as a positive RPR titer with positive TPPA confirmation (if previous titer negative) and/or 4-fold increase in RPR from historical titers. aLast 30 days. bBefore intercourse. cP ≤ .001. dP ≤ .05. Abbreviations: CAI, condomless anal intercourse; PrEP, pre-exposure prophylaxis; RPR, rapid plasma regain; TPPA, Treponema pallidum particle agglutination assay.
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