Factors associated with PrEP‐era HIV seroconversion in a 4‐year U.S. national cohort of n = 6059 sexual and gender minority individuals who have sex with men, 2017−2022

作者：Christian Grov, Yan Guo, Drew A. Westmoreland, Alexa B. D’Angelo, Chloe Mirzayi, Michelle Dearolf, Pedro B. Carneiro, Meredith Ray, David W. Pantalone, Adam W. Carrico, Viraj V. Patel, Sarit A. Golub, Sabina Hirshfield, Donald R. Hoover, Denis Nash · 发表于：Journal of the International AIDS Society · 年份：2024 · DOI：10.1002/jia2.26312 · 被引用次数：8 · 研究领域：HIV/AIDS Research and Interventions、HIV Research and Treatment、HIV, Drug Use, Sexual Risk

INTRODUCTION: Community-based cohort studies of HIV seroconversion can identify important avenues for enhancing HIV prevention efforts in the era of pre-exposure prophylaxis (PrEP). Within individuals, one can assess exposure and outcome variables repeatedly and with increased certainty regarding temporal ordering. This cohort study examined the association of several risk factors with subsequent HIV seroconversion. METHODS: We report data from a 4-year study (2017-2022) of 6059 HIV seronegative sexual and gender minority individuals who have sex with men who had indications for-, but were not using-, PrEP at enrolment. Participants completed repeat exposure assessments and self-collection of biospecimens for HIV testing. We examined the roles of race and ethnicity, socio-economic status, methamphetamine use and PrEP uptake over the course of follow-up in relation to HIV seroconversion. RESULTS: Over 4 years, 303 of the participants seroconverted across 18,421 person-years (incidence rate = 1.64 [95% CI: 1.59-1.70] per 100 person-years). In multivariable discrete-time survival analysis, factors independently associated with elevated HIV seroconversion risk included being Black/African American (adjusted risk ratio [aRR]: 2.44, 1.79-3.28), Hispanic/Latinx (1.53, 1.19-1.96), housing instability (1.58, 1.22-2.05) and past year methamphetamine use (3.82, 2.74-5.33). Conversely, time since study enrolment (24 vs. 12 months, 0.67, 0.51-0.87; 36 months, 0.60, 0.45-0.80; 48 months, 0...