{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T05:14:44Z","timestamp":1790745284401,"version":"4.1.0"},"reference-count":24,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,7,27]],"date-time":"2023-07-27T00:00:00Z","timestamp":1690416000000},"content-version":"vor","delay-in-days":26,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Daily and event\u2010driven oral pre\u2010exposure prophylaxis (PrEP) reduce the risk of HIV acquisition. PrEP use can vary over time, yet little is known about the trajectories of PrEP use irrespective of the chosen PrEP regimens among men who have sex with men (MSM).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using data from a mobile, web\u2010based diary application collected daily from 17 August 2015 until 6 May 2018, we analysed PrEP use and sexual behaviour in two large cohorts, AMPrEP (Amsterdam, the Netherlands) and Be\u2010PrEP\u2010ared (Antwerp, Belgium). In both cohorts, participants could choose between daily and event\u2010driven oral PrEP every 3 months. We used group\u2010based trajectory modelling to identify trajectories of PrEP use over time and their determinants. In addition, we estimated the incidence rate of chlamydia, gonorrhoea and syphilis within these trajectories.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 516 MSM (<jats:italic>n<\/jats:italic> = 322 AMPrEP; <jats:italic>n<\/jats:italic> = 194 Be\u2010PrEP\u2010ared), of whom 24% chose event\u2010driven PrEP at PrEP initiation. Participants contributed 225,015 days of follow\u2010up (median = 508 days [IQR = 429\u2212511]). Four distinct PrEP use trajectories were identified: \u22642 tablets per week (\u201clow frequency,\u201d 12% of the total population), 4 tablets per week (\u201cvariable,\u201d 17%), \u201calmost daily\u201d (31%) and \u201calways daily\u201d (41%). Compared to participants with \u201clow frequency\u201d PrEP use, participants with \u201cvariable\u201d (odds ratio [OR] = 2.18, 95% confidence interval [CI] = 1.04\u22124.60) and \u201calmost daily\u201d PrEP use were more often AMPrEP participants (OR = 2.64, 95% CI = 1.27\u22125.49). \u201cAlmost daily\u201d PrEP users were more often employed (OR = 6.76, 95% CI = 2.10\u221221.75) and were younger compared to participants with \u201clow frequency\u201d PrEP use. In addition, the number of days on which anal sex occurred was lower among participants with \u201clow frequency\u201d PrEP use compared to the other groups (all <jats:italic>p<\/jats:italic>&lt;0.001). Compared to \u201clow frequency\u201d PrEP users, the incidence rates of chlamydia and gonorrhoea were higher for participants with \u201calmost daily\u201d and \u201calways daily\u201d PrEP use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We uncovered four distinct PrEP use trajectories, pointing to different patterns of PrEP use in practice beyond the two\u2010regimen dichotomy. These trajectories were related to sexual behaviour and rates of sexually transmitted infection. Tailoring PrEP care according to different PrEP use patterns could be an important strategy to improve efficient PrEP delivery.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.26133","type":"journal-article","created":{"date-parts":[[2023,7,28]],"date-time":"2023-07-28T04:08:42Z","timestamp":1690517322000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Trajectories of PrEP use among men who have sex with men: a pooled analysis of two prospective, observational cohort studies"],"prefix":"10.1002","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9538-1501","authenticated-orcid":false,"given":"Vita W.","family":"Jongen","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases Public Health Service Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thijs","family":"Reyniers","sequence":"additional","affiliation":[{"name":"Department of Public Health Institute of Tropical Medicine  Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten","family":"Schim van der Loeff","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Public Health Service Amsterdam  Amsterdam The Netherlands"},{"name":"Department of Internal Medicine University of Amsterdam  Amsterdam The Netherlands"},{"name":"Amsterdam Institute for Infection and Immunity (AII)  Amsterdam The Netherlands"},{"name":"Amsterdam Public Health Research Institute (APH)  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Smekens","sequence":"additional","affiliation":[{"name":"Department of Public Health Institute of Tropical Medicine  Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0512-2109","authenticated-orcid":false,"given":"Elske","family":"Hoornenborg","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Public Health Service Amsterdam  Amsterdam The Netherlands"},{"name":"Department of Internal Medicine University of Amsterdam  Amsterdam The Netherlands"},{"name":"Amsterdam Institute for Infection and Immunity (AII)  Amsterdam The Netherlands"},{"name":"Amsterdam Public Health Research Institute (APH)  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0881-5680","authenticated-orcid":false,"given":"Mark","family":"van den Elshout","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Public Health Service Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1647-8485","authenticated-orcid":false,"given":"Hanne","family":"Zimmermann","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Public Health Service Amsterdam  Amsterdam The Netherlands"},{"name":"Department of Work and Social Psychology Maastricht University  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5830-2982","authenticated-orcid":false,"given":"Liza","family":"Coyer","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Public Health Service Amsterdam  Amsterdam The Netherlands"},{"name":"Department of Internal Medicine University of Amsterdam  Amsterdam The Netherlands"},{"name":"Amsterdam Institute for Infection and Immunity (AII)  Amsterdam The Netherlands"},{"name":"Amsterdam Public Health Research Institute (APH)  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Kenyon","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Institute of Tropical Medicine  Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1804-252X","authenticated-orcid":false,"given":"Irith","family":"De Baetselier","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Institute of Tropical Medicine  Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Udi","family":"Davidovich","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Public Health Service Amsterdam  Amsterdam The Netherlands"},{"name":"Department of Social Psychology University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry J. C.","family":"de Vries","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Public Health Service Amsterdam  Amsterdam The Netherlands"},{"name":"Amsterdam Institute for Infection and Immunity (AII)  Amsterdam The Netherlands"},{"name":"Amsterdam Public Health Research Institute (APH)  Amsterdam The Netherlands"},{"name":"Department of Dermatology University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Prins","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Public Health Service Amsterdam  Amsterdam The Netherlands"},{"name":"Department of Internal Medicine University of Amsterdam  Amsterdam The Netherlands"},{"name":"Amsterdam Institute for Infection and Immunity (AII)  Amsterdam The Netherlands"},{"name":"Amsterdam Public Health Research Institute (APH)  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Laga","sequence":"additional","affiliation":[{"name":"Department of Public Health Institute of Tropical Medicine  Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0514-4372","authenticated-orcid":false,"given":"Bea","family":"Vuylsteke","sequence":"additional","affiliation":[{"name":"Department of Public Health Institute of Tropical Medicine  Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Boyd","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Public Health Service Amsterdam  Amsterdam The Netherlands"},{"name":"Stichting HIV Monitoring  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,27]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001145"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1506273"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00056-2"},{"key":"e_1_2_11_5_1","volume-title":"What's the 2+1+1? 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