Uptake and challenges with daily oral pre-exposure prophylaxis among men who have sex with men and transgender women, suburban Yangon, Myanmar

Tun, Ni Ni; Smithuis, Frank; Tun, Nyan Lynn; Hteik, Myo Min Min; Ko, Myat Ko; Lynen, Lutgarde; Decroo, Tom; Florence, Eric; Gils, Tinne

doi:10.1093/INTHEALTH/IHAE025

Title

Uptake and challenges with daily oral pre-exposure prophylaxis among men who have sex with men and transgender women, suburban Yangon, Myanmar

Author

Tun, Ni Ni

Smithuis, Frank

Tun, Nyan Lynn

Hteik, Myo Min Min

Ko, Myat Ko

Lynen, Lutgarde

Decroo, Tom

Florence, Eric

Gils, Tinne

Abstract

Background Pre-exposure prophylaxis (PrEP) is effective for human immunodeficiency virus (HIV) prevention in risk groups. We assessed PrEP uptake and 12-month retention among men who have sex with men (MSM) and transgender women (TGW) in Myanmar during the coronavirus disease 2019 pandemic and a political crisis. Methods Using prospectively collected data, we assessed the proportion of persons eligible, initiated and retained 12 months on PrEP. We calculated HIV and syphilis incidence among those initiated on PrEP. Predictors of compliance to scheduled visits were assessed with fractional logistic regression. Results Among 652 persons screened between July and December 2020, 85.3% were eligible and 38.8% initiated PrEP. The daily pill burden was the main reason (86.5%) for refusing PrEP. A history of HIV post-exposure prophylaxis (PEP) and having an HIV-positive partner not on anti-retroviral therapy (ART) was associated with PrEP uptake (p<0.05). The 12-month retention among those initiating PrEP was 43.0%. Age >= 25 y, a history of PEP and having an HIV-positive partner not on ART predicted better compliance with scheduled visits (p<0.05). HIV incidence among PrEP initiators was 3.1 per 100 person-years (95% confidence interval [CI] 1.3 to 7.4) and syphilis incidence was 17.6 per 100 person-years (95% CI 12.3 to 25.1). Conclusions A PrEP program for MSM and TGW in Myanmar was implemented successfully under difficult circumstances. Alternative strategies are needed addressing PrEP uptake and retention.

Language

English

Source (journal)

International health. - Oxford, 2009, currens

Publication

Oxford : Oxford univ press , 2024

ISSN

1876-3413 [print]

1876-3405 [online]

DOI

10.1093/INTHEALTH/IHAE025

Volume/pages