학술논문

The Effect of Depressive Symptoms on Adherence to Daily Oral PrEP in Men who have Sex with Men and Transgender Women: A Marginal Structural Model Analysis of The iPrEx OLE Study.
Document Type
article
Source
AIDS and behavior. 20(7)
Subject
Humans
HIV Infections
Anti-HIV Agents
Administration
Oral
Cohort Studies
Depression
Sexual Behavior
Homosexuality
Male
Adult
Female
Male
Medication Adherence
Pre-Exposure Prophylaxis
Transgender Persons
Adherence
HIV prevention
Marginal structural model
Men who have sex with men
PrEP
Preexposure prophylaxis
Transgender women
iPrEx OLE
Sexual and Gender Minorities (SGM/LGBT*)
Clinical Research
Mental Health
Infectious Diseases
Public Health and Health Services
Social Work
Public Health
Language
Abstract
We assessed the role of depressive symptoms on adherence to daily oral FTC/TDF for HIV PrEP in cisgender men who have sex with men (MSM) and transgender women who have sex with men (TGW) using data from the iPrEx OLE study. A marginal structural logistic regression model was used to estimate the effect of time-varying CES-D scores on having protective levels of drug concentration, adjusting for confounding by sexual practices over time, prior adherence, and baseline demographic characteristics. We found a non-monotonic relationship between CES-D score and odds of protective FTC/TDF levels in MSM. We found evidence that the effect of depression on adherence varied between MSM and TGW, and that depressive symptoms did not contribute greatly to decreased adherence on a population scale. We recommend that depressive symptoms not preclude the prescription of PrEP, and that MSM and TGW be studied separately.