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High HIV incidence among MSM prescribed postexposure prophylaxis, 20002009: indications for ongoing sexual risk behaviour

Heuker, Joséa; Sonder, Gerard J.B.a,b; Stolte, Inekea; Geskus, Ronalda,c; van den Hoek, Annekea,b

doi: 10.1097/QAD.0b013e32834f32d8
Concise Communications

Objective: To determine (trends in) HIV incidence among MSM\ who have recently had postexposure prophylaxis (PEP) prescribed in Amsterdam, compared with MSM participating in the Amsterdam Cohort Studies (ACS).

Design and methods: We used data from MSM who were prescribed PEP in Amsterdam between 2000 and 2009, who were HIV-negative at the time of PEP prescription and had follow-up HIV testing 3 and/or 6 months after PEP prescription (n = 395). For comparison, cohort data from MSM participating in the ACS in the same period were used (n = 782). Poisson log-linear regression analyses were performed to model trends in HIV incidence and identify differences in HIV incidence between both cohorts at different time points.

Results: Between 2000 and 2009, among MSM who were prescribed PEP, an overall HIV incidence of 6.4 [95% confidence interval (CI) 3.4–11.2] per 100 person-years was found, compared with an HIV incidence of 1.6 (95% CI 1.3–2.1) per 100 person-years among MSM participating in the ACS (P < 0.01). In both cohorts, an increasing trend in HIV incidence over time was observed [incidence rate ratio (IRRpercalendaryear) 1.3 (95% CI 0.9–1.7) and 1.1 (95% CI 1.0–1.2) among MSM prescribed PEP and MSM of the ACS, respectively]. The difference in HIV incidence between both cohorts was most evident in more recent years [IRRPEPversusACS in 2009 4.8 (95% CI 2.0–11.5)].

Conclusion: Particularly in more recent years, MSM recently prescribed PEP had a higher HIV incidence compared with MSM participating in the ACS, indicating ongoing sexual risk behaviour.

aDepartment of Infectious Diseases, Public Health Service, Amsterdam

bCenter for Infection and Immunology Amsterdam (CINIMA)

cDepartment of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.

Correspondence to Gerard J.B. Sonder, Department of Infectious Diseases, Public Health Service Amsterdam, Nieuwe Achtergracht 100, P.O. Box 2200, 1000 CE Amsterdam, The Netherlands. E-mail: gsonder@ggd.amsterdam.nl

Received 24 August, 2011

Revised 18 October, 2011

Accepted 14 November, 2011

This study was presented at the 19th International Society for Sexually Transmitted Diseases Research (ISSTDR); 10–13 July 2011; Quebec City, Quebec, Canada.

© 2012 Lippincott Williams & Wilkins, Inc.