DO-PrEP
Research type
Research Study
Full title
Development of an intervention to Optimise use of pre-exposure prophylaxis (PrEP) to prevent HIV-acquisition in at-risk individuals living in Wales [DO-PrEP]
IRAS ID
250721
Contact name
David Gillespie
Contact email
Sponsor organisation
Cardiff University
Duration of Study in the UK
4 years, 11 months, 30 days
Research summary
Summary of Research
This project aims to find out i.) How individuals living in Wales use PrEP; ii.) How their use of PrEP relates to their behaviour; iii.) How their use is related to accessing other health services; iv.) What people think are the main things stopping them from using PrEP at all, or using it appropriately, and approaches that might be helpful for improving the use of PrEP. Following this, an approach will be developed for improving the use of PrEP in Wales.\n\nThe project will involve two main studies:\n\nSTUDY 1 will include 60 people who are being prescribed PrEP through sexual health clinics in Wales. The bottles in which their PrEP medication is stored will be fitted with an electronic monitor. This will record the date and time that the bottle is opened. With this, a detailed understanding of patterns of PrEP use over time will be obtained. In addition, sexual behaviour will be collected weekly using a web app. \n\nSTUDY 2 will involve interviewing between 20 and 30 people who took part in study 1 to find out how they felt about using PrEP and (if they stopped during study 1) why they stopped using PrEP and how they felt about stopping.\n\nFurther research will involve i.) searching through scientific papers to find ones that report how effective different approaches are at improving PrEP use; ii.) developing an intervention to support PrEP users. This will be developed on the basis of the accumulated evidence and in consultation with a variety of stakeholders (PrEP users, PrEP providers, advocacy representatives, and policy makers).Summary of Results
We recruited 60 participants, who provided approximately 13,000 days of PrEP use and sexual behaviour data. We interviewed 21 of these individuals. The majority of recruited participants were White British men who have sex with men and were representative of individuals accessing PrEP through sexual health clinics in Wales. Daily HIV pre-exposure prophylaxis (PrEP) use, condomless anal sex, and coverage of condomless anal sex by enough doses of PrEP was highly variable among men who have sex with men in Wales. A lot of condomless anal sex was not covered by enough doses of PrEP to provide protection against HIV. Measures aiming to control the spread of COVID-19 (introduced in March 2020 and including social distancing and avoiding physical contact with people you don’t live with) were associated with reductions in daily PrEP use, condomless anal sex, and coverage of condomless anal sex episodes by enough doses of PrEP. Our interviews highlighted distinct reasons for starting PrEP, the importance of integrating PrEP within existing routines (or making PrEP taking a habit), and clear reasons why they may stop PrEP in the future (e.g. side effects, a change in relationship status, and a requirement to pay for access). PrEP users described instances where they had experienced stigmatising behaviour from others (including healthcare professionals) and highlighted how PrEP could be used to reduce levels of stigma against people living with HIV.REC name
Wales REC 3
REC reference
19/WA/0175
Date of REC Opinion
18 Jun 2019
REC opinion
Further Information Favourable Opinion