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Evaluation of a demonstration study of daily and intermittent, event-driven PrEP for HIV prevention in men who have sex with men in Amsterdam

Projectomschrijving

Het AMPrEP (Amsterdam PrEP) project is een onderzoek naar de toepasbaarheid van PrEP voor hiv-preventie in Nederland. PrEP is een pil met hiv-remmers die een hiv-infectie kan voorkomen. De pil is bedoeld voor mensen die geen hiv hebben, maar die wel een verhoogd risico lopen om geïnfecteerd te raken. Doel van dit project is om te onderzoeken hoe PrEP werkt in de praktijk: hoeveel mensen willen PrEP gebruiken, hoe trouw worden de pillen ingenomen, hoe wordt het PrEP gebruik ervaren en zijn er veranderingen in het condoomgebruik?

Ook zal er worden gekeken naar de kosteneffectiviteit van PrEP. Dat betekent dat er onderzocht wordt hoe de kosten van het voorkómen van een hiv-infectie met PrEP zich verhouden tot de kosten van het behandelen van iemand met een hiv infectie.

Ten slotte zal, via een applicatie voor mobiele telefoon, gemeten worden hoe mensen de pillen innemen en zal onderzocht worden welke factoren van belang zijn voor een goede inname (therapietrouw).

Lees meer informatie over hiv en de onderzoeken op onze themapagina over hiv

Producten

Titel: GGD Masterclass on PrEP
Auteur: professor Sheena McCormack, senior clinical scientist, MRC Cilical Trials Unit at University College London, with several researchers in the PrEP field from GGD Amsterdam, RIVM, Universiteit van Maastricht, Academisch Medisch Centrum, HIV Transmissie Eliminatie (H-team) initiatief
Titel: Different PrEP modalities for different people: switches between daily and event-driven PrEP among MSM and Trangender persons
Auteur: Elske Hoornenborg, Liza Coyer, Roel Achterbergh, Maarten Schim van der Loeff, Udi Davidovich, Henry de Vries, Maria Prins, on behalf of the Amsterdam PrEP Project team in the HIV Transmission Elimination AMsterdam Initiative
Titel: Using a daily mobile application and dried blot spots to measure adherence to event-driven PrEP among participants of the AMPrEP cohort study
Auteur: ta W. Jongen1, Elske Hoornenborg1, Mark van den Elshout1, Liza Coyer1, Udi Davidovich1,2, Henry J.C. de Vries1,3, M. Prins1,2, Maarten F. Schim van der Loeff1,2, on behalf of the Amsterdam PrEP Project team in the HIV Transmission Elimination Amsterdam (H-TEAM) Initiative.
Link: https://nchiv.org/programme-2019/
Titel: Frequency and determinants of switching between daily and event-driven PrEP and discontinuing each regimen among men who have sex with men participating in the Amsterdam PrEP demonstration project
Auteur: Liza Coyer1, Mark van den Elshout1, Roel Achterbergh1, Maarten Schim van der Loeff1,2, Udi Davidovich1,2, Henry de Vries1,3, Maria Prins1,2, Elske Hoornenborg1, Anders Boyd1,4, on behalf of the Amsterdam PrEP Project team in the HIV Transmission Elimination AMsterdam Initiative
Link: https://nchiv.org/programme-2019/
Titel: Amsterdam PrEP project
Auteur: E. Hoornenborg, B-J Mulder
Titel: PrEP en het Amsterdam PrEP project
Auteur: E. Hoornenborg
Titel: Disclosure of PrEP use as a proxy of stigma: interim results of the Amsterdam PrEP Demonstration Project
Auteur: Roel Achterbergh, Elske Hoornenborg, Amy Matser, Maarten Schim van der Loeff, Henry de Vries, Maria Prins, Udi Davidovich, on behalf of AMPrEP in H-TEAM
Titel: USING A MOBILE APP AND DRIED BLOT SPOTS TO ASSESS ADHERENCE TO EVENT-DRIVEN PREP
Auteur: Vita W. Jongen1, Elske Hoornenborg1, Mark van den Elshout1, Liza Coyer1, Udi Davidovich1,2, Henry J.C. de Vries1,3, M. Prins1,2, Maarten F. Schim van der Loeff1,2, on behalf of the Amsterdam PrEP Project team in the HIV Transmission Elimination Amsterdam (H-TEAM) Initiative.
Titel: Tussentijdse resultaten AMPrEP project
Auteur: Elske Hoornenborg, Maria Prins
Titel: Facts and Myths about PrEP
Auteur: E. Hoornenborg, Paul Zantkuijl, Justin Mooijer, Robert Grant
Titel: HIGH PREVALENCE OF HEPATITIS-C VIRUS AMONG HIV NEGATIVE MSM IN AMSTERDAM PREP PROJECT
Auteur: Elske Hoornenborg, Maria Prins, Roel C.A. Achterbergh, Maarten F. Schim van der Loeff, Udi Davidovich, Arjan Hogewoning, Henry J.C. de Vries, Janke Schinkel, Thijs J.W. van der Laar
Link: http://www.croiconference.org
Titel: Wat hebben we geleerd van AMPrEP? Voor de soa hiv expert meeting, RIVM, juni 2019
Auteur: E. Hoornenborg
Titel: Offering a choice of daily and event-driven PrEP for MSM: a cost-effectiveness analysis
Auteur: Albert Jan van Hoek1, Maarten Reitsema1,2, Maria Xiridou1, Jacco Wallinga1,2, Birgit van Benthem1, Ard van Sighem3, Maarten Schim van der Loeff4,5, Maria Prins4, 5, Elske Hoornenborg4,6, on behalf of the Amsterdam PrEP Project team in the HIV Transmission Elimination Amsterdam (H-TEAM) Initiative
Link: https://nchiv.org/programme-2019/
Titel: Op weg naar 0 nieuwe hiv-infecties: PrEP helpt daarbij
Auteur: Elske Hoornenborg, Bas Boogmans, Kai Jonas, Paul Zantkuijl
Titel: PrEP-related stigma as assessed by late disclosure of PrEP-use among men who have sex with men
Auteur: Julian Alexander Portocarrero, Mark van den Elshout, Liza Coyer, Maria Prins, Anders Boyd, Henry de Vries, Roel Achterbergh, Thijs Reyniers, Maarten Schim van der Loeff, Udi Davidovich, Elske Hoornenborg, on behalf of the Amsterdam PrEP Project team in the HIV Transmission Elimination AMsterdam (H-TEAM) Initiative
Link: https://www.iapac.org/conferences/fast-track-cities-2019/
Titel: PrEP debacle
Auteur: Louise van Deth, Femke Roosma, Jan-Bert Vroege, Elske Hoornenborg, Jennifer Hopelezz, Linda Duits, Rob Hermanussen, en anderen
Link: https://aidsfonds.nl/actueel/het-prep-debacle-uitnodiging
Titel: Uptake and preference of daily and intermittent pre-exposure prophylaxis(PrEP) in a demonstration project: baseline characteristics and HIV prevention choices made by Dutch MSM
Auteur: E. Hoornenborg, R. Achterbergh, M. Schim van der Loeff, U. Davidovich, J. van der Helm, A. Hogewoning, G. Sonder, Y. van Duijnhoven, H. de Vries, M. Prins
Link: http://www.aids2016.org/Programme
Titel: INCIDENT HIV, HEPATITIS C AND OTHER STI IN DAILY AND EVENT-DRIVEN PREP USERS
Auteur: Elske Hoornenborg, Liza Coyer, Roel Achterbergh, Amy Matser, Udi Davidovich, Maarten Schim van der Loeff, Henry de Vries, Maria Prins, on behalf of the Amsterdam PrEP Project team in the HIV Transmission Elimination AMsterdam Initiative
Titel: Live stream - Professionals; be PrEPared!
Auteur: Roel Achterbergh, Jan van Bergen, en anderen
Link: https://www.soaaids.nl/nl/node/10907
Titel: Achieving higher adherence to daily PrEP among MSM in Amsterdam by providing feedback via a mobile application: results of a randomised clinical trial
Auteur: Mark A.M. van den Elshout, Elske Hoornenborg, Roel C.A. Achterbergh, Liza Coyer, Peter Anderson, Udi Davidovich, Henry J.C. de Vries, Maria Prins and Maarten F. Schim van der Loeff, on behalf of the Amsterdam PrEP Project team in the HIV Transmission Elimination AMsterdam Initiative (H-TEAM)
Titel: More participants prefer daily PrEP to event-driven PrEP: baseline characteristics in a Dutch PrEP demonstration project
Auteur: Elske Hoornenborg, Maria Prins, henry de Vries
Titel: ACUTE INFECTION WITH A WILD-TYPE HIV-1 VIRUS IN PREP USER WITH HIGH TDF LEVELS
Auteur: Elske Hoornenborg, Godelieve J. de Bree
Link: http://www.croiconference.org
Titel: The Positive and Negative Impact of PrEP use on the Sexual Well-being of Men who have Sex with Men (MSM) – Qualitative Results
Auteur: Zimmermann HML, Postma LR, Eekman SW, Achterbergh RCA, Prins M, Schim van der Loeff MF, de Vries HJC, Hoornenborg E, Davidovich U, on behalf of AMPrEP in HIV Transmission Elimination Team Amsterdam
Titel: PrEP: (n)iets voor jou? PrEP TALK door Aids Fonds
Auteur: Pia Dijkstra (D66, Tweede Kamerlid), Linda Voortman (GroenLinks, Tweede Kamerlid), Linda Duits (Universiteit Utrecht, gespecialiseerd in onderzoek van populaire cultuur, blogger), Laurens Buijs (UvA, doet o.a. onderzoek naar lhbt-emancipatie), Elske Hoornenborg (GGD Amsterdam, projectleider AMPrEP-studie), Kai Jonas (UvA, coördinator Europees onderzoek naar de mening over PrEP onder mensen die risico op hiv lopen) én mensen die PrEP (willen) gebruiken
Link: https://vimeo.com/channels/843798/185068532
Titel: When to put it on - Decision-making regarding condom-use among PrEP-users in Amsterdam
Auteur: Zimmermann HML1, Achterbergh RCA1,3, Prins M1,2, Schim van der Loeff MF1, de Vries HJC2,3, Hoornenborg E1,3, Davidovich U1,2
Link: https://www.iapac.org/conferences/fast-track-cities-2019/
Titel: Frequency and determinants of switching between daily or event-driven PrEP and discontinuingeach regimen in Amsterdam MSM
Auteur: L. Coyer, M. Van Den Elshout, R. Achterbergh, M. Schim Van Der Loeff, U. Davidovich, H. De Vries, M. Prins, E. Hoornenborg, A. Boyd
Titel: Country perspective on management of STIs within PrEP services, the Netherlands
Auteur: E. Hoornenborg
Titel: Cost-effectiveness of pre-exposure prophylaxis in MSM with event-driven and daily regimens.
Auteur: Maarten Reitsema Albert Jan van Hoek Maria Xiridou Jacco Wallinga Birgit van Benthem Ard van Sighem Maarten Schim van der Loeff Maria Prins Elske Hoornenborg
Titel: Pre-expositie profylaxe voor hiv preventie: update en eerste resultaten vanuit het Amsterdam PrEP project
Auteur: E. Hoornenborg, Maria Prins, Henry de Vries
Titel: The positive and negative impact of PrEP use on the sexual well-being of men who have sex with men
Auteur: Zimmermann HML1, Postma LR1, Achterbergh RCA1, Prins M1,2, Schim van der Loeff MF1,2, de Vries HJC1,3, Hoornenborg E1, Davidovich U1,2, on behalf of AMPrEP in the HIV Transmission Elimination Amsterdam (H-TEAM) initiative
Link: https://www.iapac.org/conferences/fast-track-cities-2019/
Titel: High incidence of hepatitis C virus (re-)infections among PrEP users in the Netherlands: Implications for prevention, monitoring and treatment
Auteur: Elske Hoornenborg, Liza Coyer, Roel Achterbergh, Maarten Schim van der Loeff, Sylvia Bruisten, Henry de Vries, Thijs van de Laar, Maria Prins, on behalf of the Amsterdam PrEP Project team in the HIV Transmission Elimination AMsterdam Initiative
Titel: Pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM) in the Netherlands: motives to choose for, switch to, or stop with daily or event-driven PrEP
Auteur: Zimmermann HML, Eekman SW, Achterbergh RCA, Prins M, Schim van der Loeff MF, de Vries HJC, Hoornenborg E, Davidovich U, on behalf of AMPrEP in H-team
Link: http://programme.ias2017.org/Programme/Session/145
Titel: When to put it on - Decision-making regarding condom use among PrEP users in Amsterdam
Auteur: Zimmermann HML, Achterbergh RCA, Prins M, Schim van der Loeff MF, de Vries HJC Hoornenborg E, Davidovich U, on behalf of AMPrEP in HIV Transmission Elimination Team Amsterdam
Titel: High incidence of hepatitis C virus (re-) infections among PrEP users in the Netherlands: implications for prevention, monitoring and treatment
Auteur: E Hoornenborg; L Coyer; R Achterbergh; MS van der Loeff; S Bruisten; H de Vries; T van de Laar; M Prins; on AMPrEP in H-TEAM
Titel: Overview on eligibility criteria: What have we learned of the people coming forward for PrEP?
Auteur: Elske Hoornenborg
Titel: PrEP in the Netherlands: Monitoring and reporting
Auteur: E. Hoornenborg
Titel: Amsterdam UMC PhD publicatieprijs, gewonnen door Elske Hoornenborg en Liza Coyer
Titel: OFFERING A CHOICE OF DAILY AND EVENT-DRIVEN PRE-EXPOSURE PROPHYLAXIS FOR MSM IN THE NETHERLANDS: A COST-EFFECTIVENESS ANALYSIS
Auteur: Albert Jan VAN HOEK, Maarten REITSEMA, Maria XIRIDOU, Ard VAN SIGHEM, Birgit VAN BENTHEM, Jacco WALLINGA, Yvonne van Duijnhoven, Maarten SCHIM VAN DER LOEFF, Maria PRINS, Elske HOORNENBORG, on behalf of the Amsterdam PrEP Project Team in the HIV Transmission Elimination Amsterdam (H-TEAM) Initiative.
Magazine: AIDS
Titel: Human Immunodeficiency Virus-Negative Men Who Have Sex With Men Have an Altered T-Cell Phenotype and Bioenergy Metabolism
Auteur: Zita Kruize, Irma Maurer, Karel A. van Dort, Mark A. M. van den Elshout, Elske Hoornenborg, Thijs Booiman, Maria Prins, and Neeltje A. Kootstra
Magazine: Open Forum Infectious Diseases
Link: https://academic.oup.com/ofid/article/7/8/ofaa284/5867522
Titel: MSM starting preexposure prophylaxis are at risk of hepatitis C virus infection
Auteur: Hoornenborg, Elske, Achterbergh, Roel C.A., Schim van der Loeff, Maarten F., Davidovich, Udi, Hogewoning, Arjan, de Vries, Henry J.C., Schinkel, Janke, Prins, Maria, van de Laar, Thijs J.W.
Magazine: AIDS
Titel: Pre-expositieprofylaxe (PrEP) voor preventie van hiv-infectie: op weg naar implementatie
Auteur: E. Hoornenborg, dr. H.J.C. de Vries, dr. M. F. Schim van der Loeff, dr. U. Davidovich, R.A. Achterbergh, dr. M. Prins
Magazine: Tijdschrift voor Infectieziekten
Titel: Pre-exposure prophylaxis (PrEP) for men who have sex with men in Europe: review of evidence for a much needed prevention tool
Auteur: Thijs Reyniers, Elske Hoornenborg, Bea Vuylsteke, Kristien Wouters Marie Laga
Magazine: Sexually Transmitted Infections
Titel: Change in sexual risk behaviour after 6 months of pre-exposure prophylaxis use
Auteur: Hoornenborg, Elske, Coyer, Liza, van Laarhoven, Anna, Achterbergh, Roel, de Vries, Henry, Prins, Maria, van der Loeff, Maarten Schim
Magazine: AIDS
Titel: A Mobile Application to Collect Daily Data on Preexposure Prophylaxis Adherence and Sexual Behavior Among Men Who Have Sex With Men
Auteur: Finkenflügel, Renee N.N., Hoornenborg, Elske, Achterbergh, Roel C.A., Marra, Elske, Davidovich, Udi, de Vries, Henry J.C., Prins, Maria, Schim van der Loeff, Maarten F.
Magazine: Sexually Transmitted Diseases
Link: https://journals.lww.com/stdjournal/toc/2019/06000
Titel: PrEP in Nederland. De introductie van pre-expositie profylaxe ter voorkoming van een hiv-infectie
Auteur: Elske Hoornenborg
Magazine: Tijdschrift voor Infectieziekten
Titel: Wild-type HIV infection despite PrEP: a lot to learn from a case report – Authors' reply
Auteur: Hoornenborg, Elske, Prins, Maria, Prins, Jan M, de Bree, Godelieve J
Magazine: lancet HIV
Titel: Changes in mental health and drug use among men who have sex with men using daily and event-driven pre-exposure prophylaxis: Results from a prospective demonstration project in Amsterdam, the Netherlands.
Auteur: Achterbergh RCA, Hoornenborg E, Boyd A, Coyer L, Meuzelaar SJA, Hogewoning AA, Davidovich U, van Rooijen MS, Schim van der Loeff MF, Prins M, de Vries HJC.
Magazine: EClinicalMedicine
Titel: Casus: vanaf welk moment na inname beschermt PrEP?
Auteur: Janny Dekker, Elske Hoornenborg
Magazine: SekSOA soa hiv en seksuele gezondheid
Titel: Pre-expositie profylaxe om hiv-infecties te voorkomen: een update
Auteur: Mark van den Elshout, Elske Hoornenborg
Magazine: Bijblijven
Titel: Motives to start with, choose for, switch to, or stop with daily or event-driven PrEP
Auteur: Hanne ML Zimmermann , Sanne W Eekman, Roel CA Achterbergh, Maarten F Schim van der Loeff, Maria Prins, Henry JC de Vries , Elske Hoornenborg , Udi Davidovich
Magazine: Journal of the international aids society
Link: https://onlinelibrary.wiley.com/doi/full/10.1002/jia2.25389
Titel: Acquisition of wild-type HIV-1 infection in a patient on pre-exposure prophylaxis with high intracellular concentrations of tenofovir diphosphate: a case report
Auteur: Hoornenborg, Elske, Prins, Maria, Achterbergh, Roel C A, Woittiez, Lycke R, Cornelissen, Marion, Jurriaans, Suzanne, Kootstra, Neeltje A, Anderson, Peter L, Reiss, Peter, de Vries, Henry J C, Prins, Jan M, de Bree, Godelieve J
Magazine: lancet HIV
Titel: High incidence of HCV in HIV-negative men who have sex with men using pre-exposure prophylaxis
Auteur: Elske Hoornenborg, Liza Coyer, Anders Boyd, Roel Christiaan Alfons Achterbergh, Maarten Franciscus Schim van der Loeff, Sylvia Bruisten, Henry John Christiaan de Vries, Jelle Koopsen, Thijs J W van de Laar, Maria Prins
Magazine: Journal of Hepatology
Titel: Sexual behaviour and incidence of HIV and sexually transmitted infections among men who have sex with men using daily and event-driven pre-exposure prophylaxis in AMPrEP: 2 year results from a demonstration study
Auteur: Elske Hoornenborg*, Liza Coyer*, Roel C A Achterbergh, Amy Matser, Maarten F Schim van der Loeff, Anders Boyd, Yvonne THP van Duijnhoven, Sylvia Bruisten, Paul Oostvogel, Udi Davidovich, Arjan Hogewoning, prof. Maria Prins*, prof. Henry J C de Vries*, on behalf of the Amsterdam PrEP Project team in the HIV Transmission Elimination Amsterdam Initiative. *Equally first, respectively last
Magazine: lancet HIV
Titel: Men who have sex with men more often chose daily than event-driven use of pre-exposure prophylaxis: baseline analysis of a demonstration study in Amsterdam
Auteur: Hoornenborg, Elske, Achterbergh, Roel CA, van der Loeff, Maarten F Schim, Davidovich, Udi, van der Helm, Jannie J, Hogewoning, Arjan, van Duijnhoven, Yvonne THP, Sonder, Gerard JB, de Vries, Henry JC, Prins, Maria
Magazine: Journal of the international aids society
Link: https://onlinelibrary.wiley.com/doi/epdf/10.1002/jia2.25105
Titel: Decision-making regarding condom use among daily and event-driven users of preexposure prophylaxis in the Netherlands.
Auteur: Zimmermann HML, Jongen VW, Boyd A, Hoornenborg E, Prins M, de Vries HJC, Schim van der Loeff MF, Davidovich U; Amsterdam PrEP Project Team in the HIV Transmission Elimination Amsterdam Initiative (H-TEAM).
Magazine: AIDS
Titel: PrEP in Nederland: de introductie van pre-expositieprofylaxe ter voorkoming van een hiv-infectie
Auteur: dr. E. Hoornenborg
Magazine: Tijdschrift voor Infectieziekten
Link: https://www.ariez.nl/wp-content/uploads/2020/08/TvI4_2020_Art_Hoornenborg.pdf
Titel: Grootschalige verstrekking PrEP reduceert hiv tot 0
Auteur: Frans van den Houdt
Magazine: farmaceutisch weekblad
Titel: Pre-expositie profylaxe (PrEP) om HIV-infecties te voorkomen: een update
Auteur: Mark van den Elshout, Elske Hoornenborg
Magazine: Bijblijven
Titel: Pre-expositie profylaxe (PrEP) om HIV-infecties te voorkomen: een update
Auteur: Mark van den Elshout, Elske Hoornenborg
Magazine: Bijblijven
Titel: Identification and characterization of latent classes based on drug use among men who have sex with men at risk of sexually transmitted infections in Amsterdam, the Netherlands
Auteur: Roel C. A. Achterbergh , Henry J. C. deVries, Anders Boyd, Udi Davidovich, Susanne Drückler, Elske Hoornenborg, Maria Prins & Amy Matser
Magazine: Addiction
Link: https://onlinelibrary.wiley.com/doi/full/10.1111/add.14774
Titel: Compendium of good practices in the health sector response to HIV in the WHO European Region (2018)
Auteur: World Health Organization
Titel: Bijdrage aan: PrEP-zorg online workshop, door Soaaids Nederland
Auteur: SoaAids Nederland
Link: https://moodle-sanl.nl/enrol/index.php?id=146
Titel: PrEP in the Netherlands.
Auteur: dr. Elske Hoornenborg
Link: https://reader.ogc.nl/d41b6e0c-2640-4c0c-90a7-1d5b0d23ada3.epub/
Titel: PrEP&ME
Auteur: Tim Dekkers (maker van de documentaire)
Link: http://rozefilmdagen.nl/programma/11/prep-me
Titel: Motiverende gespreksvoering in de context van hiv pre-expositie profylaxe: adviezen en handreikingen
Auteur: Elske Hoornenborg, GGD Amsterdam Kees de Jong, GGD Amsterdam Kai Jonas, Universiteit van Maastricht Remy Welleman, GGD Haaglanden Shelly Gibson, GGD Haaglanden
Titel: HIV Pre-expositie profylaxe (PrEP) richtlijn Nederland, update april 2019
Auteur: E. Hoornenborg, B. Rijnders, et al
Titel: HIV Pre-expositie profylaxe (PrEP) richtlijn Nederland
Auteur: Initiatiefnemer: Nederlandse Vereniging van Hiv Behandelaren Elske Hoornenborg en Bart Rijnders Betrokken organisaties: COC Nederland Gerrit Jan Wielinga Nederlandse Vereniging voor Dermatologie en Venereologie (NVDV) Arjan Hogewoning Nederlandse Vereniging voor Ziekenhuisapothekers (NVZA) David Burger s s s e he e e a e e a e Infectieziektebestrijding (LCI) Hannelore Götz Huisartsen Advies groep Seksuele gezondheid (SeksHAG) Jan van Bergen Rob Hermanussen Adrie Heijnen Soa Aids Nederland Hanna
Link: https://www.nvhb.nl/PrEP%20richtlijn%20Nederland%208%20september%202016.pdf

Verslagen


Samenvatting van de aanvraag

Background of the HIV epidemic among MSM in the Netherlands The HIV epidemic in the Netherlands is concentrated in men who have sex with men (MSM). MSM accounted for 71% of new HIV diagnoses in the Netherlands in 2013. Amsterdam is the epicentre of the Dutch HIV epidemic among MSM, illustrated by the fact that 45% (4,885/10,753) of HIV-positive MSM are registered at HIV treatment centres in the city of Amsterdam. In spite of intensive prevention efforts, including condom provision, free testing for HIV and sexually transmitted infections (STIs), behavioural interventions and information and awareness campaigns, the HIV incidence rate among MSM is not declining. Clearly current prevention methods are not effective in curbing the epidemic. UNAIDS set an ambitious goal for 2030: a reduction in HIV incidence by 90%. In order to reach that goal, new intervention approaches are needed. Pre-exposure prophylaxis Pre-exposure prophylaxis (PrEP) is a new prevention intervention, which was shown to significantly reduce the HIV incidence in several large, international, randomised controlled trials. The efficacy of PrEP in successful trials varied between 44% and 86%. PrEP entails taking daily (or intermittent) antiretroviral medication. The largest challenge in HIV prevention through PrEP is ensuring high adherence. Two trials, conducted in heterosexual populations in Africa, failed to show an effect of PrEP; the adherence in the study populations of these trials was very low. The drug combination most often used for PrEP is tenofovir/emtricitabine (TDF/FTC). This drug combination has been licensed by the Food and Drug Administration for use as PrEP in the USA. Both the World Health Organization and the Centers for Disease Control and Prevention recommend the use of PrEP for risk groups. In Europe, TDF/FTC has not yet been registered for a prevention indication. PrEP has only been provided in randomised controlled trials or small demonstration projects. Guidance on PrEP in European countries (who should use it; when; who should prescribe it; when; how should high adherence be ensured) is currently lacking, and there are no data on the feasibility of PrEP and its challenges in a routine public health setting in the Netherlands or other European countries. It is unknown which proportion of men would prefer intermittent, event-driven PrEP above daily PrEP. AMPrEP In Amsterdam the Public Health Service of Amsterdam (GGD) will start a PrEP demonstration project among MSM in April 2015, the Amsterdam Pre-exposure Prophylaxis project (AMPrEP). Over the course of 26 months we aim to include 370 HIV-negative MSM, who are at high risk for HIV infection. Men will be screened for eligibility; if eligible, and after providing informed consent, they will be enrolled and be able to choose between daily PrEP and intermittent, event-driven PrEP. They will be followed up 3-monthly and assessed for HIV, STIs, serum creatinine, and proteinuria. Adherence will be measured by pill count, self-report, and an online diary (through an app for mobile phone). Participants may switch PrEP modality at every visit. Follow-up will continue until 1 December 2018. The conduct of AMPrEP is funded through grants from Soa Aids Nederland, the GGD, and an in-kind contribution of the manufacturer of TDF/FTC. Aim of this study proposal The aim of this application to ZONMW is to obtain financing for the evaluation of AMPrEP and for conducting a randomized controlled trial on adherence support interventions. Research questions This study has the two main research questions: (1) What is the uptake, acceptability, usability and cost-effectiveness of a comprehensive HIV infection prevention program for MSM at risk for HIV, through two intervention modalities: (a) daily PrEP and (b) intermittent, event-driven PrEP; and does risk compensation (i.e. increases in condomless anal sex and in incidence rates of other STIs) occur among PrEP users? (2) What is the effect of individualised feedback of PrEP medication adherence on subsequent PrEP medication use? Secondary research questions concern determinants (behavioral and demographic) of modality choice; rate of and reasons for switching between PrEP modalities; occurrence and determinants of risk compensation; adherence to PrEP and determinants of good adherence; occurrence of serious adverse events; occurrence of HIV resistance mutations among those who, in spite of the intervention, acquire an HIV infection. Expected outcomes This project will provide much-needed data necessary for clinical guidance and decision making regarding PrEP implementation at national and international level. Important questions regarding demand for PrEP among MSM, acceptability, continuation rates among those who start PrEP, risk compensation, adherence, adverse events, and cost-effectiveness will be answered for the Dutch situation and inform decision-making regarding wide-spread implementation in the Netherlands.

Onderwerpen

Kenmerken

Projectnummer:
522002003
Looptijd: 100%
Looptijd: 100 %
2015
2019
Onderdeel van programma:
Gerelateerde subsidieronde:
Projectleider en penvoerder:
E. Hoornenborg
Verantwoordelijke organisatie:
GGD Amsterdam