Changes in sexual risk behavior among participants in a PrEP HIV prevention trial.
BACKGROUND
One of the concerns raised regarding the introduction of any new HIV-prevention measure, such as PrEP, is the potential for risk disinhibition or sexual risk compensation. The oral tenofovir HIV prevention trial has been the subject of international discussion in this regard.


METHODS
This article maps the changes in sexual risk behavior among women participating in the oral tenofovir HIV prevention trial in Ghana. Content-driven, thematic analysis was carried out on qualitative data obtained from in-depth interviews with study participants. Growth curve analysis was the primary method used to document trends over time in self-reported sexual behavior collected monthly.


RESULTS
Overall, the study found that sexual risk behavior did not increase during the trial. Number of sexual partners and rate of unprotected sex acts decreased across the 12-month period of study enrollment. Certain subgroups of women, however, exhibited different growth curves. Data indicate that the HIV prevention counseling associated with the trial was effective.


CONCLUSIONS
Counseling during the trial was effective. Different types of counseling and messaging may be needed for different subgroups within a population. These findings also have implications for required sample sizes for future HIV prevention trials where seroconversion is the main outcome.
Guest
Greg
G
Division of Behavioral and Biomedical Research, Family Health International, Research Triangle Park, NC 27709, USA. gguest@fhi.org
Shattuck
Dominick
D
Johnson
Laura
L
Akumatey
Betty
B
Clarke
Edith Essie Kekawo
EE
Chen
Pai-Lien
PL
MacQueen
Kathleen M
KM
D000225:Adenine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use; D003376:Counseling; D004311:Double-Blind Method; D005260:Female; D005869:Ghana; D015658:HIV Infections / Q000188:drug therapy / Q000517:prevention & control* / Q000821:virology; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D063065:Organophosphonates / Q000008:administration & dosage / Q000627:therapeutic use; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D040242:Risk Reduction Behavior; D012309:Risk-Taking; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012747:Sexual Partners; D011795:Surveys and Questionnaires; D000068698:Tenofovir; D016896:Treatment Outcome; D047568:Unsafe Sex; D055815:Young Adult
D019380:Anti-HIV Agents; D063065:Organophosphonates; D018894:Reverse Transcriptase Inhibitors; D000068698:Tenofovir; D000225:Adenine