Register      Login
Sexual Health Sexual Health Society
Publishing on sexual health from the widest perspective
RESEARCH ARTICLE (Open Access)

Dealing with pre-exposure prophylaxis-associated condom migration: changing the paradigm for men who have sex with men

Richard A. Crosby
+ Author Affiliations
- Author Affiliations

A College of Public Health at the University of Kentucky, 151 Washington Avenue, Lexington, KY 40506-0003, USA.

B The Kinsey Institute for Research in Sex, Gender, and Reproduction, 1165 East 3rd Street, Bloomington, IN 47405, USA.

C University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS 39216, USA.

D Corresponding author. Email: crosbyr3@gmail.com

Sexual Health 14(1) 106-110 https://doi.org/10.1071/SH16128
Submitted: 23 June 2016  Accepted: 29 July 2016   Published: 2 September 2016

Journal Compilation © CSIRO Publishing 2017 Open Access CC BY-NC-ND

Abstract

The behavioural aspects of pre-exposure prophylaxis (PrEP) are challenging, particularly the issue of condom migration. Three vital questions are: (1) at the population-level, will condom migration lead to increases in non-viral sexually transmissible infections?; (2) how can clinic-based counselling best promote the dual use of condoms and PrEP?; and (3) in future PrEP trials, what are the ‘best practices’ that should be used to avoid type 1 and type 2 errors that arise without accounting for condom use behaviours? This communication piece addresses each question and suggests the risk of a ‘PrEP only’ focus to widening health disparities.

Additional keywords: HIV/AIDS, measurement sexual behaviours, prevention, sexually transmissible infections.


References

[1]  Buchbinder SP, Glidden DV, Liu AY, et al HIV pre-exposure prophylaxis in men who have sex with men and transgendered women: a secondary analysis of a phase 3 randomised controlled efficacy trial. Lancet Infect Dis 2014; 14 468–75.
HIV pre-exposure prophylaxis in men who have sex with men and transgendered women: a secondary analysis of a phase 3 randomised controlled efficacy trial.Crossref | GoogleScholarGoogle Scholar | 24613084PubMed |

[2]  Office of National AIDS Policy. National HIV/AIDS strategy for the United States: updated to 2020. 2015. Available online at: https://www.aids.gov/federal-resources/national-hiv-aids-strategy/nhas-update.pdf [verified 31 July 2015].

[3]  Grant RM, Lama JR, Anderson PL, et al Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med 2010; 363 2587–99.
Preexposure chemoprophylaxis for HIV prevention in men who have sex with men.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3MXit1ansg%3D%3D&md5=6e22600cda8924441c0d2faa55711ff6CAS | 21091279PubMed |

[4]  Kelley CF, Kahle E, Sanchez T, et al Applying a PrEP continuum of care for men who have sex with men in Atlanta, Georgia. Clin Infect Dis 2015; 61 1590–7.
Applying a PrEP continuum of care for men who have sex with men in Atlanta, Georgia.Crossref | GoogleScholarGoogle Scholar |

[5]  Cohen MS, Muessig KE, Smith MK, et al Antiviral agents and HIV prevention: controversies, conflicts, and consensus. AIDS 2012; 26 1585–98.
Antiviral agents and HIV prevention: controversies, conflicts, and consensus.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC38XhtFOru7rK&md5=6048bc53a769b7486b8d7fdb245083e6CAS | 22507927PubMed |

[6]  Gamarel KE, Gollub SA. Intimacy motivations and pre-exposure prophylaxis (PrEP) adoption intentions among HIV-negative men who have sex with men (MSM) in romantic relationships. Ann Behav Med 2015; 49 177–86.
Intimacy motivations and pre-exposure prophylaxis (PrEP) adoption intentions among HIV-negative men who have sex with men (MSM) in romantic relationships.Crossref | GoogleScholarGoogle Scholar | 25124457PubMed |

[7]  Saberi P, Gemerel KE, Neilands TB, et al Ambiguity, ambivalence, and apprehension of taking HIV pre exposure prophylaxis among male couples in San Francisco: a mixed methods study. PLoS One 2012; 7 e50061
Ambiguity, ambivalence, and apprehension of taking HIV pre exposure prophylaxis among male couples in San Francisco: a mixed methods study.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC38XhslyisLrL&md5=69ca86d02bb9fb9d8eca4a4b427c21f6CAS | 23166819PubMed |

[8]  Crosby RA, Geter A, DiClemente RJ, Salazar LS. Acceptability of condoms, circumcision and PrEP among young black men who have sex with men: a descriptive study based on effectiveness and cost. Vaccines (Basel) 2014; 2 129–37.
Acceptability of condoms, circumcision and PrEP among young black men who have sex with men: a descriptive study based on effectiveness and cost.Crossref | GoogleScholarGoogle Scholar | 26344471PubMed |

[9]  Eaton LA, Driffin DD, Smith H, et al Psychosocial factors related to willingness to use pre-exposure prophylaxis for HIV prevention among Black men who have sex with men attending a community event. Sex Health 2014; 11 244–51.
Psychosocial factors related to willingness to use pre-exposure prophylaxis for HIV prevention among Black men who have sex with men attending a community event.Crossref | GoogleScholarGoogle Scholar | 25001553PubMed |

[10]  Krakower DS, Mayer KH. Anti-retrovirals for primary HIV prevention: the current status of pre and post-exposure prophylaxis. Curr HIV/AIDS Rep 2015; 12 127–38.
Anti-retrovirals for primary HIV prevention: the current status of pre and post-exposure prophylaxis.Crossref | GoogleScholarGoogle Scholar | 25600106PubMed |

[11]  Mansergh G, Koblin BA, Sullivan PS. Challenges for HIV pre-exposure prophylaxis among men who have sex with men in the United States PLoS Med 2012; 9 e1001286
Challenges for HIV pre-exposure prophylaxis among men who have sex with men in the United StatesCrossref | GoogleScholarGoogle Scholar | 22927797PubMed |

[12]  Gilmore HJI, Liu A, Koesler KA, et al Participant experiences and facilitators and barriers to pill use among men who have sex with men in the iPrEx pre-exposure prophylaxis trial in San Francisco. AIDS Patient Care STDS 2013; 27 560–6.
Participant experiences and facilitators and barriers to pill use among men who have sex with men in the iPrEx pre-exposure prophylaxis trial in San Francisco.Crossref | GoogleScholarGoogle Scholar |

[13]  Crosby RA, Warner L. Pending issues in male condom use promotion. Sex Health 2008; 5 317–9.
Pending issues in male condom use promotion.Crossref | GoogleScholarGoogle Scholar |

[14]  Curran JW, Crosby RA. Preexposure prophylaxis (PrEP): who will benefit and what are the challenges? Am J Prev Med 2013; 44 S163–6.
Preexposure prophylaxis (PrEP): who will benefit and what are the challenges?Crossref | GoogleScholarGoogle Scholar | 23253761PubMed |

[15]  Crosby RA, Ricks J, Young A. Condom migration resulting from circumcision, microbicides, and vaccines: brief review and methodological considerations. Sex Health 2012; 9 96–102.
Condom migration resulting from circumcision, microbicides, and vaccines: brief review and methodological considerations.Crossref | GoogleScholarGoogle Scholar |

[16]  Golub SA, Kowalazyk W, Weinberger CL, et al Pre-exposure prophylaxis and predicted condom use among high risk men who have sex with men. J Acquir Immune Defic Syndr 2010; 54 548–55.
Pre-exposure prophylaxis and predicted condom use among high risk men who have sex with men.Crossref | GoogleScholarGoogle Scholar | 20512046PubMed |

[17]  Roye CF. Condom use by Hispanic and African-American adolescent girls who use hormonal contraception. J Adolesc Health 1998; 23 205–11.
Condom use by Hispanic and African-American adolescent girls who use hormonal contraception.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1cvjsVWhsg%3D%3D&md5=9e48408f147aa203219303c902b5df30CAS | 9763156PubMed |

[18]  Weisman CS, Plichta S, Nathanson CA, Ensminger M, Robinson JC. Consistency of condom use for diseases prevention among adolescent users of oral contraceptives. Fam Plann Perspect 1991; 23 71–4.
Consistency of condom use for diseases prevention among adolescent users of oral contraceptives.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK3M3osFSrtw%3D%3D&md5=9b799f5f0704f70f4d8c5424d17b82fdCAS | 2060614PubMed |

[19]  Sieving R, Bearinger L, Remafedi G, Taylor BA, Harmon B. Cognitive and behavioral predictors of sexually transmitted diseases risk behavior among sexually active adolescents. Arch Pediatr Adolesc Med 1997; 151 243–51.
Cognitive and behavioral predictors of sexually transmitted diseases risk behavior among sexually active adolescents.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2s3js1SisA%3D%3D&md5=3ba6df0722809f1ca4621c7098193eb1CAS |

[20]  Cooper ML, Agocha VB, Powers AM. Motivations for condom use: do pregnancy prevention goals undermine diseases prevention among heterosexual young adults? Health Psychol 1999; 18 464–74.
Motivations for condom use: do pregnancy prevention goals undermine diseases prevention among heterosexual young adults?Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1Mvks12msw%3D%3D&md5=bc23d9d95e033e1fa478303a260cf2e5CAS | 10519462PubMed |

[21]  Crosby RA, DiClemente RJ, Wingood GM, et al Correlates of continued risky sex among pregnant African-American teens: implications for STD prevention. Sex Transm Dis 2003; 30 57–63.
Correlates of continued risky sex among pregnant African-American teens: implications for STD prevention.Crossref | GoogleScholarGoogle Scholar | 12514444PubMed |

[22]  Lang D, Salazar LF, DiClemente RJ, Crosby RA, et al Determinant of multimethod contraceptive use in a sample of adolescent women diagnosed with psychological disorders. Infect Dis Obstet Gynecol 2011; 90 212–23.

[23]  Centers for Disease Control and Prevention. Lifetime risk of HIV diagnosis in the United States. 2016. Available online at: http://www.cdc.gov/nchhstp/newsroom/docs/factsheets/lifetime-risk-hiv-dx-us.pdf [verified 2 August 2015].

[24]  Black AIDS Institute. Back of the line: the state of AIDS among Black gay men in America 2012. Available online at: http://www.Blackaids.org/index.php?option=com_content&view=article&id=1284&Itemid=198 [verified 3 March 2016].

[25]  Auerbach JD, Hoppe TA. Beyond “getting drugs into bodies”: social science perspectives on pre-exposure prophylaxis for HIV. J Int AIDS Soc 2015; 18 19983
Beyond “getting drugs into bodies”: social science perspectives on pre-exposure prophylaxis for HIV.Crossref | GoogleScholarGoogle Scholar | 26198346PubMed |

[26]  Fauci AS, Marston HD. Ending the HIV-AIDS pandemic – follow the science. N Engl J Med 2015; 373 2197–9.
Ending the HIV-AIDS pandemic – follow the science.Crossref | GoogleScholarGoogle Scholar | 26624554PubMed |

[27]  Centers for Disease Control and Prevention. Reported cases of STDs on the rise in the United States. 2015. Available online at: http://www.cdc.gov/nchhstp/newsroom/2015/std-surveillance-report-press-release.html [verified 30 January 2016].

[28]  Volk JE, Marcus JL, Pengrasamy T, et al No new HIV infections with increasing use of HIV preexposure prophylaxis in a clinical practice setting. Clin Infect Dis 2016;
No new HIV infections with increasing use of HIV preexposure prophylaxis in a clinical practice setting.Crossref | GoogleScholarGoogle Scholar |

[29]  Koester KA, Grant RM. Keeping our eyes on the prize: no new HIV infections with increased use of pre-exposure prophylaxis. Clin Infect Dis 2015; 61 1604–5.
Keeping our eyes on the prize: no new HIV infections with increased use of pre-exposure prophylaxis.Crossref | GoogleScholarGoogle Scholar | 26334051PubMed |

[30]  Van Damme L, Corneli A, Ahmed K, Agot K, Lombaard J, Kapiga S, et al Preexposure prophylaxis for HIV infection among African women. N Engl J Med 2012; 367 411–22.
Preexposure prophylaxis for HIV infection among African women.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC38XhtlSltrbL&md5=a210351da18cd86f597fdd85a79b7f2bCAS | 22784040PubMed |

[31]  Marrazzo J, Ramjee G, Ricahrdson BA, et al Tenofovir-based pre-exposure prophylaxis for HIV infection among African women. N Eng J Med 2015; 372 509–18.

[32]  Green LW, Glasgow RE. Evaluating the relevance, generalization, and applicability of research: issues in external validation and translation methodology. Eval Health Prof 2006; 29 126–53.
Evaluating the relevance, generalization, and applicability of research: issues in external validation and translation methodology.Crossref | GoogleScholarGoogle Scholar | 16510882PubMed |

[33]  Molina JM, Capitent C, Spire B, et al On-demand preexposure prophylaxis in men at high risk for HIV-1 infection. N Engl J Med 2015; 373 2237–46.
On-demand preexposure prophylaxis in men at high risk for HIV-1 infection.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC28XntFSnsLc%3D&md5=af2ecb0d01037a9c93f407579f51b170CAS | 26624850PubMed |

[34]  Underhill K, Operario D, Skeer M, et al Packaging PrEP to prevent HIV: an integrated framework to plan for pre-exposure prophylaxis implementation in clinical practice. J Acquir Immune Defic Syndr 2010; 55 8–13.
Packaging PrEP to prevent HIV: an integrated framework to plan for pre-exposure prophylaxis implementation in clinical practice.Crossref | GoogleScholarGoogle Scholar | 21423876PubMed |

[35]  Marcus JL, Buiskey T, Horvath T, et al Potential interventions to support adherence to HIV pre-exposure prophylaxis (PrEP): a systematic review. HIV Med 2014; 15 385–95.
Potential interventions to support adherence to HIV pre-exposure prophylaxis (PrEP): a systematic review.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC2cXhtFajtr%2FJ&md5=e1be3572001e61637eb7e1476d8d6c13CAS | 24580813PubMed |

[36]  Crosby RA, Cates W. Condom use: still a sexual health staple. Sex Health 2012; 9 1–3.
Condom use: still a sexual health staple.Crossref | GoogleScholarGoogle Scholar | 22348626PubMed |

[37]  Crosby RA, DiClemente RJ, Holtgrave DR, Wingood GM. Design, measurement, and analytic considerations for testing hypotheses relative to condom effectiveness against non-viral STIs. Sex Transm Infect 2002; 78 228–31.
Design, measurement, and analytic considerations for testing hypotheses relative to condom effectiveness against non-viral STIs.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD38vjvFehtQ%3D%3D&md5=ed4cc73034ee0c242dc2b19fe6481d65CAS |

[38]  Crosby RA, Charnigo R, Weathers C, et al Condom effectiveness against non-viral sexually transmitted infections: a prospective study using electronic daily diaries. Sex Transm Infect 2012; 88 484–9.
Condom effectiveness against non-viral sexually transmitted infections: a prospective study using electronic daily diaries.Crossref | GoogleScholarGoogle Scholar |

[39]  Crosby RA, DiClemente RJ, Charnigo R, et al A brief, clinic-based, safer sex intervention for African American men at-risk of HIV acquisition: a randomized controlled trial. Am J Public Health 2009; 99 S96–S103.
A brief, clinic-based, safer sex intervention for African American men at-risk of HIV acquisition: a randomized controlled trial.Crossref | GoogleScholarGoogle Scholar |

[40]  Crosby RA, Charnigo RJ, Salazar LF, Pasternak R, Terrell I, Ricks J, Taylor S. Enhancing condom use among young black males: a randomized controlled trial. Am J Public Health 2014; 104 2219–25.
Enhancing condom use among young black males: a randomized controlled trial.Crossref | GoogleScholarGoogle Scholar | 25211749PubMed |

[41]  Kamb ML, Fishbein M, Douglas JM, et al Efficacy of risk-reduction counseling to prevent human immunodeficiency virus and sexually transmitted diseases: a randomized controlled trial. JAMA 1998; 280 1161–7.
Efficacy of risk-reduction counseling to prevent human immunodeficiency virus and sexually transmitted diseases: a randomized controlled trial.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1cvkvFantA%3D%3D&md5=f5cc16aa3b83e3327187078494795934CAS | 9777816PubMed |

[42]  Smith DK, Herbst JH, Zhang X, Rose CE. Condom effectiveness for HIV prevention by consistency of use among men who have sex with men in the United States. J Acquir Immune Defic Syndr 2015; 68 337–44.
Condom effectiveness for HIV prevention by consistency of use among men who have sex with men in the United States.Crossref | GoogleScholarGoogle Scholar |

[43]  Graham CA, Crosby RA, Sanders SA, Yarber WL. Assessment of condom use in men and women. Annu Rev Sex Res 2006; 16 2–52.

[44]  Crosby RA. State of condom use in HIV prevention science and practice. Curr HIV/AIDS Rep 2013; 10 59–64.
State of condom use in HIV prevention science and practice.Crossref | GoogleScholarGoogle Scholar | 23224425PubMed |

[45]  Mayer K, Safren SA, Haberer J, Mimiaga M. Project PrEPARE: high levels of medication adherence with continued condomless sex in U.S. men who have sex with men in an oral PrEP adherence trial. AIDS Human Retroviruses 2014; 30 23–4.

[46]  Crosby RA, DiClemente RJ, Yarber WL, et al An event-specific analysis of condom breakage among African American men at risk of HIV acquisition. Sex Transm Dis 2008; 35 174–7.
An event-specific analysis of condom breakage among African American men at risk of HIV acquisition.Crossref | GoogleScholarGoogle Scholar |

[47]  Warner L, Macaluso M, Austin HD, Kleinbaum DK, Artz L, Fleenor ME, et al Application of the case crossover design to reduce unmeasured confounding in studies of condom effectiveness. Am J Epidemiol 2005; 161 765–73.
Application of the case crossover design to reduce unmeasured confounding in studies of condom effectiveness.Crossref | GoogleScholarGoogle Scholar | 15800269PubMed |

[48]  Baeten JM, Donnell D, Ndase P, et al Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. N Engl J Med 2012; 367 399–410.
Antiretroviral prophylaxis for HIV prevention in heterosexual men and women.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC38XhtlSltrbK&md5=3cb82387c09c4694dae4fa80e1fa8ad3CAS | 22784037PubMed |

[49]  Thigpen MC, Kebaabetswe PM, Paxton LA, et al Antiretroviral pre-exposure prophylaxis for heterosexual HIV transmission in Botswana. N Engl J Med 2012; 367 423–34.
Antiretroviral pre-exposure prophylaxis for heterosexual HIV transmission in Botswana.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC38XhtlSltrbE&md5=06ad452c0b2648054b2e24effdfd7b92CAS | 22784038PubMed |

[50]  Grant RM, Anderson PL, McMahan V, et al Uptake of pre-exposure prophylaxis, sexual practices, and HIV incidence in men and transgender women who have sex with men: a cohort study. Lancet Infect Dis 2014; 14 820–9.
Uptake of pre-exposure prophylaxis, sexual practices, and HIV incidence in men and transgender women who have sex with men: a cohort study.Crossref | GoogleScholarGoogle Scholar | 25065857PubMed |

[51]  Hoots BE, Finlayson T, Nerlander L, Paz-Bailey G, NHBS study group. Willingness to take, use of, and indications for pre-exposure prophylaxis among men who have sex with men – 20 U.S. cities, 2014. Clin Infect Dis 2016; ciw367
Willingness to take, use of, and indications for pre-exposure prophylaxis among men who have sex with men – 20 U.S. cities, 2014.Crossref | GoogleScholarGoogle Scholar |

[52]  Kuhns LM, Reisner SL, Mimiaga MJ, Gayles T, Shelendiah M, Garofalo R. Correlates of PrEP indication in a multi-site cohort of young HIV-uninfected transgender women. AIDS Behav 2016; 20 1470–7.
Correlates of PrEP indication in a multi-site cohort of young HIV-uninfected transgender women.Crossref | GoogleScholarGoogle Scholar | 26336946PubMed |

[53]  Crosby RA, Graham CA, Yarber WL, Sanders SA, Milhausen R, Mena L. Measures of attitudes toward and communication about condom use: their relationship with sexual risk behavior among young Black MSM. Sex Transm Dis 2016; 43 94–8.
Measures of attitudes toward and communication about condom use: their relationship with sexual risk behavior among young Black MSM.Crossref | GoogleScholarGoogle Scholar | 26766525PubMed |

[54]  Millett GA, Peterson JL, Flores SA, Hart TA, Jeffries WL, Wilson PA, et al Comparisons of disparities and risks of HIV infection in black and other men who have sex with men in Canada, UK, and USA: a meta-analysis. Lancet 2012; 380 341–8.
Comparisons of disparities and risks of HIV infection in black and other men who have sex with men in Canada, UK, and USA: a meta-analysis.Crossref | GoogleScholarGoogle Scholar | 22819656PubMed |

[55]  Mannheimer S, Wang L, Wilton C, et al Infrequent HIV testing and late HIV diagnosis are common among a cohort of Black men who have sex with men (BMSM) in six U.S. cities. J Acquir Immune Defic Syndr 2014; 67 438–45.
Infrequent HIV testing and late HIV diagnosis are common among a cohort of Black men who have sex with men (BMSM) in six U.S. cities.Crossref | GoogleScholarGoogle Scholar | 25197830PubMed |