{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T15:33:45Z","timestamp":1766158425357,"version":"build-2065373602"},"reference-count":21,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2019,12,9]],"date-time":"2019-12-09T00:00:00Z","timestamp":1575849600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: There are limited studies on the medication regimen of pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM) in China. This study compared the effectiveness of and adherence to two prophylactic HIV medication regimens, which provided evidence and guidance for the application and promotion of the PrEP strategy in the MSM population in China. Methods: We conducted an open, non-randomized, multicenter, parallel, controlled clinical intervention study in western China. Subjects were recruited by convenience sampling at research centers in Chongqing, Guangxi, Xinjiang and Sichuan, China from April 2013 to March 2015, and they were categorized into the daily PrEP, event-driven and blank control groups. Tenofovir disoproxil fumarate (TDF; 300 mg\/dose) was administered to subjects in the daily PrEP and event-driven groups, and all subjects were followed up every 12 weeks for 96 weeks. Demographic, behavioral, psychological characteristics and AIDS-related attitudes were assessed using self-completed questionnaires. TDF serum concentrations in subjects in Chongqing and Sichuan were quantified after systematic sampling. Results: Of the 2422 enrolled MSM, 856 were eligible for statistical analysis (PrEP group: 385 and event-driven group: 471); 30 and 32 subjects in daily PrEP and event-driven groups, respectively, were HIV-positive; the incidence of HIV infection was as follows: daily PrEP group, 6.60 cases\/100 person-years and event-driven group, 5.57 cases\/100 person-years (relative risk (RR) 95% confidence interval (CI) was 0.844 (0.492\u20131.449)); HIV incidence did not differ significantly when stratified by medication adherence or sites. When the medication adherence rate was \u226580%, the median TDF serum concentrations were 0.458 mg\/L, and 0.429 mg\/L in the daily PrEP, and event-driven groups, respectively (not significant; p &gt; 0.05); Subjects who were in the event-driven PrEP group (OR = 2.152, 95% CI: 1.566\u20132.957), had fewer male sexual partners in the last two weeks (OR = 0.685, 95% CI: 0.563\u20130.834), were one year older on average (OR = 1.022, 95% CI: 1.002\u20131.043), considered that medication kept them safe, were less worried about others knowing they took medicine and were more likely to have high adherence. Conclusions: The efficacies of daily TDF and event-driven TDF use were not significantly different in preventing new infections among HIV-negative MSM. Event-driven TDF use is economical and effective and is worth popularizing. Our results provide evidence for the application and promotion of the PrEP strategy in the MSM population in China.<\/jats:p>","DOI":"10.3390\/ijerph16244996","type":"journal-article","created":{"date-parts":[[2019,12,9]],"date-time":"2019-12-09T05:54:51Z","timestamp":1575870891000},"page":"4996","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Study on Pre-Exposure Prophylaxis Regimens among Men Who Have Sex with Men: A Prospective Cohort Study"],"prefix":"10.3390","volume":"16","author":[{"given":"Dan","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China"},{"name":"Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China"},{"name":"Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing 400016, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hao","family":"Tao","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China"},{"name":"Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China"},{"name":"Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing 400016, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianghong","family":"Dai","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics, School of Public Health, Xinjiang Medical University, Xinjiang 830011, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hao","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 520021, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ailong","family":"Huang","sequence":"additional","affiliation":[{"name":"Key Laboratory of Molecular Biology, Ministry of Molecular Biology, Infectious Diseases, Chongqing Medical University, Chongqing 400016, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoni","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China"},{"name":"Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China"},{"name":"Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing 400016, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2019,12,9]]},"reference":[{"key":"ref_1","unstructured":"(2019, March 05). UNAIDS. Available online: http:\/\/www.unaids.org\/en\/resources\/documents\/2018\/unaids-data-2018."},{"key":"ref_2","first-page":"707","article-title":"Characteristics of HIV sexually transmission and challenges for controlling the epidemic in China","volume":"39","author":"Wu","year":"2018","journal-title":"Zhonghua Liu Xing Bing Xue Za Zhi"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/S2055-6640(20)30260-0","article-title":"Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine HIV pre-exposure prophylaxis: Clinical guidelines","volume":"4","author":"Wright","year":"2018","journal-title":"J. Virus Erad."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1016\/S1473-3099(14)70937-5","article-title":"Single-Agent Tenofovir versus Combination Emtricitabine\/Tenofovir for Pre-Exposure Prophylaxis against HIV-1 Acquisition: A Randomized Trial","volume":"14","author":"Baeten","year":"2014","journal-title":"Lancet Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1056\/NEJMoa1108524","article-title":"Antiretroviral prophylaxis for HIV prevention in heterosexual men and women","volume":"367","author":"Baeten","year":"2012","journal-title":"N. Engl. J. Med."},{"key":"ref_6","unstructured":"Molina, J.-M., Capitant, C., Charreau, I., Meyer, L., Spire, B., Pialoux, G., Chidiac, C., Delfraissy, J.-F., and Tremblay, C. (2019, November 09). On Demand PrEP with Oral TDF-FTC in MSM: Results of the ANRS Ipergay Trial. Available online: https:\/\/www.avac.org\/sites\/default\/files\/u3\/clarity_on_PrEP_SLIDES.pdf."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"j5011","DOI":"10.1136\/bmj.j5011","article-title":"Recent advances in PrEP for HIV","volume":"359","author":"Desai","year":"2017","journal-title":"BMJ"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2587","DOI":"10.1056\/NEJMoa1011205","article-title":"Preexposure chemoprophylaxis for HIV prevention in men who have sex with men","volume":"363","author":"Grant","year":"2010","journal-title":"N. Engl. J. Med."},{"key":"ref_9","first-page":"2226","article-title":"Awareness, experience and willingness of using HIV pre-exposure prophylaxis among men who have sex with men","volume":"35","author":"Zhang","year":"2013","journal-title":"J. Third Mil. Med. Univ."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e11","DOI":"10.2196\/resprot.6767","article-title":"Pre-Exposure prophylaxis (PrEP) as an additional tool for HIV prevention among men who have sex with men in Belgium: The Be-PrEP-ared Study Protocol","volume":"6","author":"Reyniers","year":"2017","journal-title":"JMIR Res. Protoc."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e25105","DOI":"10.1002\/jia2.25105","article-title":"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","volume":"21","author":"Hoornenborg","year":"2018","journal-title":"J. Int. AIDS Soc."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1155\/2015\/964512","article-title":"Cost effectiveness of \u2018on demand\u2019 HIV pre-exposure prophylaxis for non-injection drug-using men who have sex with men in Canada","volume":"26","author":"Ouellet","year":"2015","journal-title":"Can. J. Infect. Dis. Med. Microbiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1080\/09540121.2016.1146653","article-title":"Uptake of PrEP and condom and sexual risk behavior among MSM during the ANRS IPERGAY trial","volume":"28","author":"Demoulin","year":"2016","journal-title":"AIDS Care"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1097\/QAI.0000000000000993","article-title":"PrEP adherence patterns strongly impact individual HIV risk and observed efficacy in randomized clinical trials","volume":"72","author":"Dimitrov","year":"2016","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"21842","DOI":"10.7448\/IAS.20.1.21842","article-title":"Alignment of adherence and risk for HIV acquisition in a demonstration project of pre-exposure prophylaxis among HIV serodiscordant couples in Kenya and Uganda: A prospective analysis of prevention-effective adherence","volume":"20","author":"Haberer","year":"2017","journal-title":"J. Int. AIDS Soc."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Haberer, J.E., Baeten, J.M., Campbell, J., Wangisi, J., Katabira, E., Ronald, A., Tumwesigye, E., Psaros, C., Safren, S.A., and Ware, N.C. (2013). Adherence to antiretroviral prophylaxis for HIV prevention: A substudy cohort within a clinical trial of serodiscordant couples in East Africa. PLoS Med., 10.","DOI":"10.1371\/journal.pmed.1001511"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"19533","DOI":"10.7448\/IAS.17.4.19533","article-title":"Socio-economic factors and virological suppression among people diagnosed with HIV in the United Kingdom: Results from the ASTRA study","volume":"17","author":"Burch","year":"2014","journal-title":"J. Int. AIDS Soc."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1071\/SH16083","article-title":"Mental health in 2020 for men who have sex with men in the United States","volume":"14","author":"Batchelder","year":"2017","journal-title":"Sex. Health"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1186","DOI":"10.3724\/SP.J.1008.2012.01186","article-title":"Pre-exposure prophylaxis for HIV high-risk groups: An analysis of clinical adherence","volume":"32","author":"Gao","year":"2012","journal-title":"Acad. J. Second Mil. Med. Univ."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1007\/s11121-017-0799-8","article-title":"Risk perception, sexual behaviors, and PrEP adherence among substance-using men who have sex with men: A qualitative study","volume":"18","author":"Storholm","year":"2017","journal-title":"Prev. Sci."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1007\/s10461-017-1951-y","article-title":"Utility of different adherence measures for PrEP: Patterns and incremental value","volume":"22","author":"Abaasa","year":"2018","journal-title":"AIDS Behav."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/16\/24\/4996\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:40:31Z","timestamp":1760190031000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/16\/24\/4996"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,9]]},"references-count":21,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2019,12]]}},"alternative-id":["ijerph16244996"],"URL":"https:\/\/doi.org\/10.3390\/ijerph16244996","relation":{},"ISSN":["1660-4601"],"issn-type":[{"type":"electronic","value":"1660-4601"}],"subject":[],"published":{"date-parts":[[2019,12,9]]}}}