TY - JOUR
T1 - Awareness, discussion and non-prescribed use of HIV pre-exposure prophylaxis among persons living with HIV/AIDS in Italy
T2 - A Nationwide, cross-sectional study among patients on antiretrovirals and their treating HIV physicians
AU - Palummieri, Antonio
AU - De Carli, Gabriella
AU - Rosenthal, Éric
AU - Cacoub, Patrice
AU - Mussini, Cristina
AU - Puro, Vincenzo
AU - Ladisa, Nicoletta
AU - Maggiolo, Franco
AU - Rizzi, Marco
AU - Calza, Leonardo
AU - Colangeli, Vincenzo
AU - Girometti, Nicolò
AU - Ferraresi, Alice
AU - Focà, Emanuele
AU - Giorgetti, Pier Francesco
AU - Pezzoli, Maria Chiara
AU - Celesia, Benedetto Maurizio
AU - Pinzone, Marilia Rita
AU - Bruno, Tiziana
AU - Viada, Alberto
AU - Vitullo, Davide
AU - Guardigni, Viola
AU - Sighinolfi, Laura
AU - Ambu, Silvia
AU - Bartolozzi, Dario
AU - Campolmi, Irene
AU - Meli, Massimo
AU - Pozzi, Marco
AU - Sterrantino, Gaetana
AU - Matarazzo, Filippo
AU - Purificato, Francesco
AU - Anzalone, Enza
AU - Luciano, Sarracino
AU - Castagna, Antonella
AU - Cinque, Paola
AU - Fumagalli, Luca
AU - Gianotti, Nicola
AU - Nozza, Silvia
AU - Uberti-Foppa, Caterina
AU - Ammassari, Adriana
AU - Bellagamba, Rita
AU - Cicalini, Stefania
AU - Liuzzi, Giuseppina
AU - Loiacono, Laura
AU - Migliorisi, Paolo
AU - Nicastri, Emanuele
AU - Pinnetti, Carmela
AU - Sampaolesi, Alessandro
AU - Zaccarelli, Mauro
AU - De Luca, Andrea
AU - The PrEPventHIV Italy Study Group
PY - 2017/11/28
Y1 - 2017/11/28
N2 - Background: Before Pre-Exposure Prophylaxis (PrEP) was officially recommended and made available, a few surveys among gay and bisexual men, and persons living with HIV/AIDS (PLWHA), identified an informal use of antiretrovirals (ARVs) for PrEP among HIV-negative individuals. Before PrEP availability in Italy, we aimed to assess whether PLWHA in Italy shared their ARVs with HIV-negative individuals, whether they knew people who were on PrEP, and describe the level of awareness and discussion on this preventive measure among them and people in their close circle. Methods: Two anonymous questionnaires investigating personal characteristics and PrEP awareness, knowledge, and experience were proposed to HIV specialists and their patients on ARVs in a one-week, cross-sectional survey (December 2013-January 2014). Among PLWHA, a Multivariable Logistic Regression analysis was conducted to identify factors associated with PrEP discussion with peers (close circle and/or HIV associations), and experience (use in close circle and/or personal ARV sharing). Results: Eighty-seven specialists in 31 representative Infectious Diseases departments administered the questionnaire to 1405 PLWHA. Among specialists, 98% reported awareness, 65% knew the dosage schedule, and 14% had previously suggested or prescribed PrEP. Among PLWHA, 45.6% were somehow aware, discussed or had direct or indirect experience of PrEP: 38% "had heard" of PrEP, 24% were aware of studies in HIV-negative individuals demonstrating a risk reduction through the use of ARVs, 22% had discussed PrEP, 12% with peers; 9% reported PrEP use in close circle and 1% personal ARV sharing. Factors predictive of either PrEP discussion with peers or experience differed between men and women, but across all genders were mainly related to having access to information, with HIV association membership being the strongest predictor. Conclusions: At a time and place where there were neither official information nor proposals or interventions to guide public policies on PrEP in Italy, a significant number of PLWHA were aware of it, and approximately 10% reported PrEP use in their close circle, although they rarely shared their ARVs with uninfected people for this purpose. Official policies and PrEP availability, along with implementation programs, could avoid risks from uncontrolled PrEP procurement and self-administration practices.
AB - Background: Before Pre-Exposure Prophylaxis (PrEP) was officially recommended and made available, a few surveys among gay and bisexual men, and persons living with HIV/AIDS (PLWHA), identified an informal use of antiretrovirals (ARVs) for PrEP among HIV-negative individuals. Before PrEP availability in Italy, we aimed to assess whether PLWHA in Italy shared their ARVs with HIV-negative individuals, whether they knew people who were on PrEP, and describe the level of awareness and discussion on this preventive measure among them and people in their close circle. Methods: Two anonymous questionnaires investigating personal characteristics and PrEP awareness, knowledge, and experience were proposed to HIV specialists and their patients on ARVs in a one-week, cross-sectional survey (December 2013-January 2014). Among PLWHA, a Multivariable Logistic Regression analysis was conducted to identify factors associated with PrEP discussion with peers (close circle and/or HIV associations), and experience (use in close circle and/or personal ARV sharing). Results: Eighty-seven specialists in 31 representative Infectious Diseases departments administered the questionnaire to 1405 PLWHA. Among specialists, 98% reported awareness, 65% knew the dosage schedule, and 14% had previously suggested or prescribed PrEP. Among PLWHA, 45.6% were somehow aware, discussed or had direct or indirect experience of PrEP: 38% "had heard" of PrEP, 24% were aware of studies in HIV-negative individuals demonstrating a risk reduction through the use of ARVs, 22% had discussed PrEP, 12% with peers; 9% reported PrEP use in close circle and 1% personal ARV sharing. Factors predictive of either PrEP discussion with peers or experience differed between men and women, but across all genders were mainly related to having access to information, with HIV association membership being the strongest predictor. Conclusions: At a time and place where there were neither official information nor proposals or interventions to guide public policies on PrEP in Italy, a significant number of PLWHA were aware of it, and approximately 10% reported PrEP use in their close circle, although they rarely shared their ARVs with uninfected people for this purpose. Official policies and PrEP availability, along with implementation programs, could avoid risks from uncontrolled PrEP procurement and self-administration practices.
KW - Anti-HIV agents
KW - HIV physicians
KW - HIV prevention
KW - Persons Living with HIV/AIDS (PLWHA)
KW - Pre-Exposure Prophylaxis (PrEP)
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U2 - 10.1186/s12879-017-2819-5
DO - 10.1186/s12879-017-2819-5
M3 - Article
AN - SCOPUS:85035141315
VL - 17
JO - BMC Infectious Diseases
JF - BMC Infectious Diseases
SN - 1471-2334
IS - 1
M1 - 734
ER -