Examining the Longitudinal Predictive Relationship Between HIV Treatment Outcomes and Pre-exposure Prophylaxis Use by Serodiscordant Male Couples

• Type of Material: Article
• Authors: Harry Jin, Brown University; Katie Biello, Brown University; Robert Garofalo, Ann & Robert H. Lurie Children’s Hospital of Chicago; Mark Lurie, Brown University; Patrick Sullivan, Emory University; Robert Stephenson, Emory University; Matthew J Mimiaga, Brown University
• Language: English
• Date: 2021-01-01
• Publisher: LIPPINCOTT WILLIAMS & WILKINS
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2020 Wolters Kluwer Health, Inc. All rights reserved.
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1097/QAI.0000000000002522
• Title of Journal or Parent Work: JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
• Volume: 86
• Issue: 1
• Start Page: 38
• End Page: 45
• Grant/Funding Information: Research reported in this publication was supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health under Award Number R01HD075655 (MPIs: Drs. Garofalo, Mimiaga, and Stephenson). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. None of the authors declare any conflicts of interest.
• Keywords: serodiscordant; Immunology; ADHERENCE; Science & Technology; PARTNERS; ANTIRETROVIRAL PROPHYLAXIS; MEN; Infectious Diseases; CONDOMLESS ANAL SEX; men who have sex with men; Life Sciences & Biomedicine; antiretroviral therapy; INFECTION; pre-exposure prophylaxis

Abstract

BACKGROUND: Men who have sex with men are disproportionately burdened by HIV/AIDS, and the advent of pre-exposure prophylaxis (PrEP) has provided an effective strategy to reduce the risk of HIV transmission. Research has shown that improving one partner's health-promoting behaviors increases the likelihood that their partner adopts healthier behaviors. We examined the longitudinal relationship between favorable HIV treatment outcomes with current PrEP use among HIV serodiscordant male partners. SETTING: Data are from Project Stronger Together, a randomized controlled trial that recruited serodiscordant male couples from Atlanta, GA; Boston, MA; and Chicago, IL. METHODS: Serodiscordant couples completed assessments at baseline, 6, 12, 18, and 24 months. We analyzed longitudinal data from 120 HIV serodiscordant male partners to assess the relationship between the HIV-negative partner's current PrEP use and their HIV-positive partner's current ART use, ART adherence, and viral load using generalized estimating equation models. RESULTS: Fewer than half of the HIV-negative partners were on PrEP at baseline and nearly two-thirds of their HIV-positive partners were virally suppressed. HIV-negative male partners who had partners with an undetectable viral load had greater odds of being a current PrEP user than HIV-negative partners with partners with a detectable viral load. CONCLUSION: Our study highlights the need to develop dyad-level interventions to improve HIV medication use/adherence by HIV serodiscordant male couples. Our findings also suggest that dyad-level interventions may be able to leverage our understanding of how partners can influence each other's health-promoting behaviors to develop programs that improve health outcomes for both partners.