Evaluation of Sexual Risk Behavior Among Study Participants in the TDF2 PrEP Study Among Heterosexual Adults in Botswana

October 2016 - Behavioral Prevention

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Gust, D.A., Soud, F., Hardnett, F., et al. Journal of Acquired Immune Deficiency Syndromes (August 2016), Epub ahead of print, doi: 10.1097/QAI.0000000000001143.

This longitudinal study (2007–2010) examined whether heterosexual men and women participating in a pre-exposure prophylaxis (PrEP) trial changed sexual behaviors, including condom use and number of sexual partners. The 1,200 participants received PrEP, risk reduction counseling, condoms, and screening for sexually transmitted infections. They were interviewed about their sexual behaviors at baseline and each month to determine if risk compensation was taking place. Among participants, the odds of reporting using a condom during sex increased by 23 percent each year. Participants who reported having at least one condomless sexual encounter were more likely to have herpes simplex virus 2, be male, and report early sexual debut (≤15 years). The odds of reporting no sexual activity increased by 2 percent each year. Among participants who reported at least one sexual encounter in the past 30 days, the rate of reported sexual activity diminished by 3 percent each year. Men and participants who initiated sexual activity at ≤15 years were more likely to increase the number of their sexual partners during the study. Overall findings indicated that PrEP programs can be effectively implemented without increasing risk compensation. This study actually showed a reduction in the number of condomless sexual acts and an increase in the number of participants reporting no sexual partners.

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