Skip to main content

High PrEP uptake, adherence, persistence and effectiveness outcomes among young Thai men and transgender women who sell sex in Bangkok and Pattaya, Thailand: findings from the open-label combination HIV prevention effectiveness (COPE) study.

Publication ,  Journal Article
Weir, BW; Wirtz, AL; Chemnasiri, T; Baral, SD; Decker, M; Dun, C; Hnin Mon, SH; Ungsedhapand, C; Dunne, EF; Woodring, J; Pattanasin, S ...
Published in: Lancet Reg Health Southeast Asia
August 2023

BACKGROUND: Daily oral pre-exposure prophylaxis (PrEP) is effective in preventing HIV infection, but no study has evaluated combination prevention interventions with PrEP for transgender women (TGW) and men who have sex with men (MSM) who sell sex. METHODS: The Combination Prevention Effectiveness (COPE) study was a community-based, non-randomized implementation study in Bangkok and Pattaya, Thailand. Participants were HIV-negative MSM and TGW aged 18-26 years who reported exchanging sex with men in the prior 12 months and who met 2014 U.S. Public Health Service PrEP eligibility criteria. The intervention included quarterly HIV testing, semiannual testing for sexually transmitted infections, provision of condoms with lubricant, and the opportunity to initiate or end daily oral PrEP use at any time during study participation. Participants taking PrEP received monthly adherence counseling and short message service reminders. The primary outcome was HIV incidence rate ratio (IRR) on PrEP vs. not on PrEP. Secondary outcomes were PrEP initiation, PrEP use at 12 months, and PrEP adherence. FINDINGS: From October 2017 to August 2019, 846 participants were enrolled: 531 (62.8%) immediately initiated PrEP; 104 (12.3%) subsequently initiated PrEP, and 211 (24.9%) never initiated PrEP. Among those initiating PrEP within 30 days of enrollment; 85.9% were on PrEP at the 12-months. When taking PrEP, participants reported adherent PrEP use at 94.2% of quarterly assessments. Ten HIV seroconversions occurred without PrEP use (incidence rate [IR] = 3.42 per 100 person-years [PY]; 95% CI = 1.64-6.30), while zero cases occurred with PrEP use (IR = 0.0 per 100PY; 95% CI = 0.0-0.62), with IRR = 0.0 (95% CI = 0.0-0.22; p < 0.001). INTERPRETATION: Young Thai MSM and TGW who exchange sex can have high PrEP uptake, persistence and adherence, and low HIV incidence when offered in supportive community-based settings. FUNDING: U.S. National Institute of Allergy and Infectious Diseases; Centers for Disease Control and Prevention.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Lancet Reg Health Southeast Asia

DOI

EISSN

2772-3682

Publication Date

August 2023

Volume

15

Start / End Page

100217

Location

England
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Weir, B. W., Wirtz, A. L., Chemnasiri, T., Baral, S. D., Decker, M., Dun, C., … COPE Study Team, . (2023). High PrEP uptake, adherence, persistence and effectiveness outcomes among young Thai men and transgender women who sell sex in Bangkok and Pattaya, Thailand: findings from the open-label combination HIV prevention effectiveness (COPE) study. Lancet Reg Health Southeast Asia, 15, 100217. https://doi.org/10.1016/j.lansea.2023.100217
Weir, Brian W., Andrea L. Wirtz, Tareerat Chemnasiri, Stefan D. Baral, Michele Decker, Chen Dun, Sandra Hsu Hnin Mon, et al. “High PrEP uptake, adherence, persistence and effectiveness outcomes among young Thai men and transgender women who sell sex in Bangkok and Pattaya, Thailand: findings from the open-label combination HIV prevention effectiveness (COPE) study.Lancet Reg Health Southeast Asia 15 (August 2023): 100217. https://doi.org/10.1016/j.lansea.2023.100217.
Weir BW, Wirtz AL, Chemnasiri T, Baral SD, Decker M, Dun C, Hnin Mon SH, Ungsedhapand C, Dunne EF, Woodring J, Pattanasin S, Sukwicha W, Thigpen MC, Varangrat A, Warapornmongkholkul A, O’Connor S, Ngo JP, Qaragholi N, Sisel HI, Truong JM, Janyam S, Linjongrat D, Sriplienchan S, Sirivongrangson P, Rooney JF, Sullivan P, Chua-Intra B, Hickey AC, Beyrer C, COPE Study Teamabcdefghijklmn, COPE Study Team. High PrEP uptake, adherence, persistence and effectiveness outcomes among young Thai men and transgender women who sell sex in Bangkok and Pattaya, Thailand: findings from the open-label combination HIV prevention effectiveness (COPE) study. Lancet Reg Health Southeast Asia. 2023 Aug;15:100217.

Published In

Lancet Reg Health Southeast Asia

DOI

EISSN

2772-3682

Publication Date

August 2023

Volume

15

Start / End Page

100217

Location

England