TY - JOUR AU - Hoenigl, Martin AU - Jain, Sonia AU - Moore, David AU - Collins, Deborah AU - Sun, Xiaoying AU - Anderson, Peter AU - Corado, Katya AU - Blumenthal, Jill AU - Daar, Eric AU - Milam, Joel AU - Dubé, Michael AU - Morris, Sheldon T1 - Substance Use and Adherence to HIV Preexposure Prophylaxis for Men Who Have Sex with Men T2 - Emerging Infectious Disease journal PY - 2018 VL - 24 IS - 12 SP - 2292 SN - 1080-6059 AB - The effectiveness of oral HIV preexposure prophylaxis (PrEP) strongly depends on maintaining adherence. We investigated the association between substance use and PrEP adherence, as well as incident sexually transmitted infections (STIs) in a high-risk cohort of 394 participants (391 men who have sex with men and 3 transgender women) who were enrolled in a PrEP demonstration project. We assessed baseline and ongoing substance use over a 48-week period for stimulants and nonstimulant substances and for each substance separately. We measured PrEP adherence by using dried blood spots to obtain levels of tenofovir diphosphate. No differences in these levels were found between substance users and nonsubstance users. Baseline stimulant use was strongly associated (odds ratio 3.4; p<0.001) with incident STIs during the study. Thus, PrEP adherence was not decreased by substance use. Because substance users had increased rates of STIs, indicating higher-risk behavior, they might be excellent candidates for PrEP. KW - substance use KW - adherence to HIV preexposure prophylaxis KW - PrEP KW - HIV KW - viruses KW - HIV and other retroviruses KW - methamphetamine KW - alcohol KW - injection drug use KW - dried blood spots KW - adherence KW - men who have sex with men KW - MSM KW - transgender women KW - sexually transmitted infections KW - persons who injected drugs DO - 10.3201/eid2412.180400 UR - https://wwwnc.cdc.gov/eid/article/24/12/18-0400_article ER - End of Reference