Awareness, discussion and non-prescribed use of HIV pre-exposure prophylaxis among persons living with HIV/AIDS in Italy: A Nationwide, cross-sectional study among patients on antiretrovirals and their treating HIV physicians

Antonio Palummieri, Gabriella De Carli, Éric Rosenthal, Patrice Cacoub, Cristina Mussini, Vincenzo Puro, Nicoletta Ladisa, Franco Maggiolo, Marco Rizzi, Leonardo Calza, Vincenzo Colangeli, Nicolò Girometti, Alice Ferraresi, Emanuele Focà, Pier Francesco Giorgetti, Maria Chiara Pezzoli, Benedetto Maurizio Celesia, Marilia Rita Pinzone, Tiziana Bruno, Alberto ViadaDavide Vitullo, Viola Guardigni, Laura Sighinolfi, Silvia Ambu, Dario Bartolozzi, Irene Campolmi, Massimo Meli, Marco Pozzi, Gaetana Sterrantino, Filippo Matarazzo, Francesco Purificato, Enza Anzalone, Sarracino Luciano, Antonella Castagna, Paola Cinque, Luca Fumagalli, Nicola Gianotti, Silvia Nozza, Caterina Uberti-Foppa, Adriana Ammassari, Rita Bellagamba, Stefania Cicalini, Giuseppina Liuzzi, Laura Loiacono, Paolo Migliorisi, Emanuele Nicastri, Carmela Pinnetti, Alessandro Sampaolesi, Mauro Zaccarelli, Andrea De Luca, The PrEPventHIV Italy Study Group

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Article number734
JournalBMC Infectious Diseases
Volume17
Issue number1
DOIs
Publication statusPublished - Nov 28 2017

Keywords

  • Anti-HIV agents
  • HIV physicians
  • HIV prevention
  • Persons Living with HIV/AIDS (PLWHA)
  • Pre-Exposure Prophylaxis (PrEP)

ASJC Scopus subject areas

  • Infectious Diseases

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    Palummieri, A., De Carli, G., Rosenthal, É., Cacoub, P., Mussini, C., Puro, V., Ladisa, N., Maggiolo, F., Rizzi, M., Calza, L., Colangeli, V., Girometti, N., Ferraresi, A., Focà, E., Giorgetti, P. F., Pezzoli, M. C., Celesia, B. M., Pinzone, M. R., Bruno, T., ... The PrEPventHIV Italy Study Group (2017). Awareness, discussion and non-prescribed use of HIV pre-exposure prophylaxis among persons living with HIV/AIDS in Italy: A Nationwide, cross-sectional study among patients on antiretrovirals and their treating HIV physicians. BMC Infectious Diseases, 17(1), [734]. https://doi.org/10.1186/s12879-017-2819-5