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Volume 24, Number 12—December 2018
CME ACTIVITY - Research

Substance Use and Adherence to HIV Preexposure Prophylaxis for Men Who Have Sex with Men1

Martin HoeniglComments to Author , Sonia Jain, David Moore, Deborah Collins, Xiaoying Sun, Peter L. Anderson, Katya Corado, Jill S. Blumenthal, Eric S. Daar, Joel Milam, Michael P. Dubé, Sheldon Morris, and for the California Collaborative Treatment Group 595 Team
Author affiliations: Medical University of Graz, Graz, Austria (M. Hoenigl); University of California, San Diego, California, USA (M. Hoenigl, S. Jain, D. Moore, X. Sun, J.S. Blumenthal, S. Morris); Department of Health and Human Services, Long Beach, California, USA (D. Collins); University of Anschutz Medical Campus, Aurora, Colorado, USA (P.L. Anderson); Harbor UCLA Medical Center, Torrance, California, USA (K. Corado, E.S. Daar); University of Southern California Keck School of Medicine, Los Angeles, California, USA (J. Milam, M.P. Dubé)

Main Article

Table 2

Associations of DAST10 and AUDIT results at baseline and ongoing substance/alcohol use with primary and secondary DBS adherence endpoints for MSM and transgender women, California, USA*

Characteristic
Primary endpoint
p value
Secondary endpoint
p value
No
Yes
No
Yes
Substance use baseline, n = 394
DAST10 problems 0.80 0.55
No/low 70 (28) 179 (72) 173 (69) 76 (31)
Moderate 37 (31) 83 (69) 86 (72) 34 (28)
Substantial/severe 8 (32) 17 (68) 20 (80) 5 (20)
AUDIT score 0.09 0.84
<8 81 (29) 201 (71) 197 (70) 85 (30)
8–15 25 (26) 70 (74) 69 (73) 26 (27)
>15 9 (53) 8 (47) 13 (76) 4 (24)
Ongoing substance use, n = 394
Methamphetamine 0.82 0.32
No 97 (29) 238 (71) 240 (72) 95 (28)
Some 10 (28) 26 (72) 26 (72) 10 (28)
Frequent 8 (35) 15 (65) 13 (57) 10 (43)
Heroin 0.79 >0.99
No 113 (29) 275 (71) 274 (71) 114 (29)
Some 1 (25) 3 (75) 3 (75) 1 (25)
Frequent 1 (50) 1 (50) 2 (100) 0
Poppers 0.54 0.66
No 62 (31) 139 (69) 146 (73) 55 (27)
Some 32 (30) 75 (70) 75 (70) 32 (30)
Frequent 21 (24) 65 (76) 58 (67) 28 (33)
Cocaine 0.48 0.33
No 97 (29) 241 (71) 236 (70) 102 (30)
Some 13 (29) 32 (71) 33 (73) 12 (27)
Frequent 5 (45) 6 (55) 10 (91) 1 (9)
Stimulant substances† 0.37 0.75
No 42 (30) 100 (70) 98 (69) 44 (31)
Some 43 (33) 88 (67) 96 (73) 35 (27)
Frequent 30 (25) 91 (75) 85 (71) 36 (29)
Nonstimulant substances‡ 0.96 0.32
No 67 (30) 158 (70) 166 (74) 59 (26)
Some 31 (28) 79 (72) 74 (67) 36 (33)
Frequent 17 (29) 42 (71) 39 (66) 20 (34)
Any substance‡ 0.34 >0.99
No 31 (30) 71 (70) 72 (71) 30 (29)
Some 47 (33) 97 (67) 102 (71) 42 (29)
Frequent 37 (25) 111 (75) 105 (71) 43 (29)
Alcohol 0.27 0.88
No 23 (38) 38 (62) 42 (69) 19 (31)
Some 32 (29) 79 (71) 78 (70) 33 (30)
Frequent 60 (27) 162 (73) 159 (72) 63 (28)

*Values are no. (%). Primary endpoint value was TFV-DP >719 fmol/punch; secondary endpoint value was TFV-DP >1,246 fmol/punch. For baseline use data for specific substances and substance classes not shown, all p values were >0.2. AUDIT, Alcohol Use Disorders Identification Test; DAST, Drug Abuse Screening Test; DBS, dried blood spot; MSM, men who have sex with men; TSF-DV, tenofovir diphosphate.
†Includes poppers, methamphetamine, cocaine, ecstasy, amphetamine, and other stimulants.
‡Marijuana and alcohol excluded.

Main Article

1Original data from this study were presented in part at the 2017 Conference on Retroviruses and Opportunistic Infections, February 13–16, 2017, Seattle, Washington, USA; and at the 12th International Conference on HIV Treatment and Prevention Adherence, June 4–6, 2017, Miami, Florida, USA.

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