1. Awareness, discussion and non-prescribed use of HIV pre-exposure prophylaxis among persons living with HIV/AIDS in Italy: a Nationwide, cross-sectional study among patients on antiretrovirals and their treating HIV physicians
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Palummieri, Antonio, De Carli, Gabriella, Rosenthal, Éric, Cacoub, Patrice, Mussini, Cristina, Puro, Vincenzo, Ladisa, Nicoletta, Maggiolo, Franco, Rizzi, Marco, Calza, Leonardo, Colangeli, Vincenzo, Girometti, Nicolò, Ferraresi, Alice, Focà, Emanuele, Giorgetti, Pier Francesco, Pezzoli, Maria Chiara, Celesia, Benedetto Maurizio, Pinzone, Marilia Rita, Bruno, Tiziana, Viada, Alberto, Vitullo, Davide, Guardigni, Viola, Sighinolfi, Laura, Ambu, Silvia, Bartolozzi, Dario, Campolmi, Irene, Meli, Massimo, Pozzi, Marco, Sterrantino, Gaetana, Matarazzo, Filippo, Purificato, Francesco, Anzalone, Enza, Luciano, Sarracino, Lichtner, Miriam, Raffaella, Marocco, Mercurio, Vito Sante, Lorena, Paula Castelli, Martorelli, Paoli, Linzalone, Angela, Esoka, Franklyn, Raise, Eseme Enzo, Bossolasco, Simona, Castagna, Antonella, Cernuschi, Massimo, Cinque, Paola, Fumagalli, Luca, Gaiera, Giovanni, Gianotti, Nicola, Guffanti, Monica, Maillard, Miriam, Nozza, Silvia, Spagnuolo, Vincenzo, Uberti-Foppa, Caterina, Borghi, Vanni, Cristina Mussini, Null, Chessa, Luchino, Matta, Laura, Pasetto, Maria Cristina, D'Esposito, Giuseppe, Franco, Alfredo, Izzo, Crescenzo Maria, Manzillo, Elio, Marocco, Alessandro, Micillo, Raffaele, Pizzella, Teresa, Martini, Salvatore, Moretti, Maria Vittoria, Schiaroli, Elisabetta, Catalani, Corrado, Giorgi, Marina, Menichini, Beatrice, Trezzi, Michele, Migliore, Simona, Ballardini, Giuseppe, Barchi, Enrico, Garlassi, Elisa, Magnani, Giacomo, Prati, Francesca, Testa, Lucia, Ursitti, Maria Alessandra, Zoboli, Giuliana, Teti, Elisabetta, Buonomini, Anna Rita, Cerva, Carlotta, Giovanni D'Anna, Null, Ilari, Barbara, Malagnino, Vincenzo, Sarmati, Loredana, Ammassari, Adriana, Bellagamba, Rita, Evangelo, Boumis, Cicalini, Stefania, Liuzzi, Giuseppina, Loiacono, Laura, Migliorisi, Paolo, Nicastri, Emanuele, Pinnetti, Carmela, Sampaolesi, Alessandro, Tommasi, Chiara, Zaccarelli, Mauro, Angileri, Rosalia, Coscia, Maria, D'Ettorre, Gabriella, Fantauzzi, Alessandra, Iaiani, Giancarlo, Mezzaroma, Ivano, Paoletti, Francesca, Zaccaria, Maria, De Luca, Andrea, Rossetti, Barbara, Pomi, Manola, Carnicelli, Nicoletta, Gonnelli, Angela, Marri, Daniele, Toscano, Lucia, Armignacco, Orlando, Caterini, Anna Rita, Caterini, Antonio Luciano, Di Filippo, Barbara, Ialungo, Anna Maria, Rastrelli, Elena, Sabatini, Rita, Palummieri, A, De Carli, G, Rosenthal, É, Cacoub, P, Mussini, C, Puro, V, the PrEPventHIV Italy Study, Group, Castagna, A, Spagnuolo, V, and Uberti-Foppa, C
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0301 basic medicine ,Male ,Anti-HIV agents ,Pediatrics ,Health Knowledge, Attitudes, Practice ,Cross-sectional study ,Alternative medicine ,Psychological intervention ,Human immunodeficiency virus (HIV) ,HIV Infections ,Self Medication ,Anti-HIV agent ,Logistic regression ,medicine.disease_cause ,Pre-exposure prophylaxis ,Sexual and Gender Minorities ,0302 clinical medicine ,Surveys and Questionnaires ,030212 general & internal medicine ,HIV physician ,Dosing regimen ,virus diseases ,Persons Living with HIV/AIDS (PLWHA) ,Infectious Diseases ,Italy ,HIV physicians ,Female ,Research Article ,Adult ,medicine.medical_specialty ,Sexual Behavior ,HIV prevention ,lcsh:Infectious and parasitic diseases ,03 medical and health sciences ,Acquired immunodeficiency syndrome (AIDS) ,Physicians ,medicine ,Humans ,lcsh:RC109-216 ,Acquired Immunodeficiency Syndrome ,business.industry ,medicine.disease ,030112 virology ,Pre-Exposure Prophylaxis (PrEP) ,Cross-Sectional Studies ,Family medicine ,Pre-Exposure Prophylaxis ,business - Abstract
Background Before Pre-Exposure Prophylaxis (PrEP) was officially recommended and made available, a few surveys among gay and bisexual men, and persons living with HIV/AIDS (PLWHA), identified an informal use of antiretrovirals (ARVs) for PrEP among HIV-negative individuals. Before PrEP availability in Italy, we aimed to assess whether PLWHA in Italy shared their ARVs with HIV-negative individuals, whether they knew people who were on PrEP, and describe the level of awareness and discussion on this preventive measure among them and people in their close circle. Methods Two anonymous questionnaires investigating personal characteristics and PrEP awareness, knowledge, and experience were proposed to HIV specialists and their patients on ARVs in a one-week, cross-sectional survey (December 2013–January 2014). Among PLWHA, a Multivariable Logistic Regression analysis was conducted to identify factors associated with PrEP discussion with peers (close circle and/or HIV associations), and experience (use in close circle and/or personal ARV sharing). Results Eighty-seven specialists in 31 representative Infectious Diseases departments administered the questionnaire to 1405 PLWHA. Among specialists, 98% reported awareness, 65% knew the dosage schedule, and 14% had previously suggested or prescribed PrEP. Among PLWHA, 45.6% were somehow aware, discussed or had direct or indirect experience of PrEP: 38% “had heard” of PrEP, 24% were aware of studies in HIV-negative individuals demonstrating a risk reduction through the use of ARVs, 22% had discussed PrEP, 12% with peers; 9% reported PrEP use in close circle and 1% personal ARV sharing. Factors predictive of either PrEP discussion with peers or experience differed between men and women, but across all genders were mainly related to having access to information, with HIV association membership being the strongest predictor. Conclusions At a time and place where there were neither official information nor proposals or interventions to guide public policies on PrEP in Italy, a significant number of PLWHA were aware of it, and approximately 10% reported PrEP use in their close circle, although they rarely shared their ARVs with uninfected people for this purpose. Official policies and PrEP availability, along with implementation programs, could avoid risks from uncontrolled PrEP procurement and self-administration practices. Electronic supplementary material The online version of this article (10.1186/s12879-017-2819-5) contains supplementary material, which is available to authorized users.
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- 2017