503. Influence of HIV Pre-Exposure Prohylaxis (PrEP) on Risk Behavior in an HIV Prevention Program in Houston, TX
Session: Poster Abstract Session: HIV Prep and PEP
Thursday, October 27, 2016
Room: Poster Hall
Background: A comprehensive HIV Prevention Program at Thomas Street Health Center (TSHC) in Houston, TX established in July 2013 outside of a formal demonstration project or clinical trial, in a free-standing HIV clinic, provides a venue for investigating the potential influence of pre-exposure prophylaxis (PrEP) on number of sexual partners and condom use among patients at risk for HIV.

Methods: Patients ≥ 18 years old presenting for confidential walk-up rapid HIV testing at TSHC who tested HIV negative were assessed for risk and, if appropriate, were invited to participate in the prevention program, which provides counseling, condoms, and PrEP as appropriate. All 271 people identified as at-risk by the tester were invited to complete surveys at baseline and 6 months and chart review.  Of those, 183 clients followed-up for MD evaluation. Data included demographics, sero-discordance, sexual orientation, having multiple sex partners, recent bacterial sexually transmitted infection, condom use, and PrEP use. Logistic regression models were used to assess associations between risk factors and decreased condom use.

Results: Baseline and 6-month data was available for 96 patients. Sixty patients also had chart review data available. Most participants (65%) were male. About 40% were Black non-Hispanic, 16% White non-Hispanic, 31% Hispanic and 13% other. Average age was 39 years (range 18 to 67). Twenty-four participants (41%) were MSM, and 48% were in a serodiscordant relationship. In addition, 27% started PrEP.

At 6 months 36% had decreased condom use; however this was not predicted by gender, race/ethnicity, or PrEP use. However, subjects with HIV positive partners were unlikely to have decreased condom use, p=0.004 (adjusted OR 0.23, 95% CI 0.08, 0.63) as were those with same or decreased numbers of partners, p=0.04 (adjusted OR 0.24, 95%CI 0.06, 0.92). Mean baseline number of sexual partners was 2.5 (range 0,30), with 16% reporting increased number of sexual partners at 6 month. PrEP use did not predict increase in partners.

Conclusion: In a real-world setting among high-risk patients, both subjects with an HIV positive partner and subjects with decreasing numbers of partners over time were unlikely to use condoms less. PrEP use did not predict increased risk behavior.

Charlene Flash, MD, MPH1, Xiaoying Yu, MD, MS, PhD2, Syundai Johnson, BS1, Oluwatobi Adegboyega, MBBS, MPH1, Kenneth Mayer, MD3 and Thomas P. Giordano, M.D., M.P.H., FIDSA4, (1)Baylor College of Medicine, Houston, TX, (2)Baylor College of Medicine and Study Design and Analysis Core, Baylor-UTHouston Center for AIDS Research, Houston, TX, (3)Infectious Disease Division, Beth Israel Deaconess Medical Center, Boston, MA, (4)Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX


C. Flash, Gilead Sciences: Scientific Advisor , Educational grant , Grant recipient , Research grant , Research support and Speaker honorarium

X. Yu, None

S. Johnson, None

O. Adegboyega, None

K. Mayer, Gilead Sciences: Investigator , Research grant

T. P. Giordano, None

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