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This study aimed to document HIV seroconversion and associated determinants, PrEP adherence, plasma drug concentrations, and HIV drug resistance in MSM using event-driven or daily PrEP in Burkina Faso, C\u00f4te d\u2019Ivoire, Mali, and Togo.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective cohort study was conducted in 2017\u20132021 among HIV-seronegative MSM aged 18 or over who were at high risk of HIV infection. Participants could choose between event-driven and daily PrEP, switch regimens, and discontinue or restart PrEP. The determinants of HIV incidence were investigated using a multivariate mixed-effects Poisson regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 647 participants were followed for a total time of 1229.3 person-years. Of 5371 visits, event-driven PrEP was chosen in 3873 (72.1%), and daily PrEP in 1400 (26.1%). HIV incidence was 2.4 per 100 person-years (95% confidence interval [CI] 1.5\u20133.6) for event-driven PrEP, and 0.6 per 100 person-years (95% CI .1\u20132.3) for daily PrEP (adjusted incidence rate ratio 4.40, 95% CI 1.00\u201319.36, P = .050). Adequate adherence was lower with event-driven than daily PrEP (44.3% vs 74.9%, P &amp;lt; .001). Plasma drug concentrations were undetectable in 92 (97.9%) of the 94 measures taken for 23 participants who seroconverted. Only 1 participant had resistance to PrEP drugs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>HIV seroconversions mainly occurred in participants who chose event-driven PrEP. The study's data highlighted major difficulties with adherence to this regimen. Improving adherence to event-driven PrEP constitutes a major research and public health priority in this context.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciad221","type":"journal-article","created":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T10:58:22Z","timestamp":1681383502000},"page":"606-614","source":"Crossref","is-referenced-by-count":22,"title":["Human Immunodeficiency Virus Seroconversion Among Men Who Have Sex With Men Who Use Event-Driven or Daily Oral Pre-Exposure Prophylaxis (CohMSM-PrEP): A Multi-Country Demonstration Study From West Africa"],"prefix":"10.1093","volume":"77","author":[{"given":"Christian","family":"Laurent","sequence":"first","affiliation":[{"name":"TransVIHMI, Univ Montpellier, IRD, Inserm , Montpellier , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Issifou","family":"Yaya","sequence":"additional","affiliation":[{"name":"TransVIHMI, Univ Montpellier, IRD, Inserm , Montpellier , 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