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

The PrEPventHIV Italy Study Group; Antonio Palummieri; Gabriella De Carli; Éric Rosenthal; Patrice Cacoub; Cristina Mussini; Vincenzo Puro; Nicoletta Ladisa; Franco Maggiolo; Marco Rizzi; Leonardo Calza; Vincenzo Colangeli; Nicolò Girometti; Alice Ferraresi; Emanuele Focà; Pier Francesco Giorgetti; Maria Chiara Pezzoli; Benedetto Maurizio Celesia; Marilia Rita Pinzone; Tiziana Bruno; Alberto Viada; Davide Vitullo; Viola Guardigni; Laura Sighinolfi; Silvia Ambu; Dario Bartolozzi; Irene Campolmi; Massimo Meli; Marco Pozzi; Gaetana Sterrantino; Filippo Matarazzo; Francesco Purificato; Enza Anzalone; Sarracino Luciano; Miriam Lichtner; Marocco Raffaella; Vito Sante Mercurio; Paula Castelli Lorena; Paoli Martorelli; Angela Linzalone; Franklyn Esoka; Eseme Enzo Raise; Simona Bossolasco; Antonella Castagna; Massimo Cernuschi; Paola Cinque; Luca Fumagalli; Giovanni Gaiera; Nicola Gianotti; Monica Guffanti; Miriam Maillard; Silvia Nozza; Vincenzo Spagnuolo; Caterina Uberti-Foppa; Vanni Borghi; Luchino Chessa; Laura Matta; Maria Cristina Pasetto; Giuseppe D'Esposito; Alfredo Franco; Crescenzo Maria Izzo; Elio Manzillo; Alessandro Marocco; Raffaele Micillo; Teresa Pizzella; Salvatore Martini; Maria Vittoria Moretti; Elisabetta Schiaroli; Corrado Catalani; Marina Giorgi; Beatrice Menichini; Michele Trezzi; Simona Migliore; Giuseppe Ballardini; Enrico Barchi; Elisa Garlassi; Giacomo Magnani; Francesca Prati; Lucia Testa; Maria Alessandra Ursitti; Giuliana Zoboli; Elisabetta Teti; Anna Rita Buonomini; Carlotta Cerva; D'Anna Giovanni D'Anna; Barbara Ilari; Vincenzo Malagnino; Loredana Sarmati; Adriana Ammassari; Rita Bellagamba; Boumis Evangelo; Stefania Cicalini; Giuseppina Liuzzi; Laura Loiacono; Paolo Migliorisi; Emanuele Nicastri; Carmela Pinnetti; Alessandro Sampaolesi; Chiara Tommasi; Mauro Zaccarelli; Rosalia Angileri; Maria Coscia; Gabriella d'Ettorre; Alessandra Fantauzzi; Giancarlo Iaiani; Ivano Mezzaroma; Francesca Paoletti; Maria Zaccaria; Andrea De Luca; Barbara Rossetti; Manola Pomi; Nicoletta Carnicelli; Angela Gonnelli; Daniele Marri; Lucia Toscano; Orlando Armignacco; Anna Rita Caterini; Antonio Luciano Caterini; Barbara Di Filippo; Anna Maria Ialungo; Elena Rastrelli; Rita Sabatini

doi:10.1186/s12879-017-2819-5

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

The PrEPventHIV Italy Study Group, Antonio Palummieri, Gabriella De Carli, Éric Rosenthal, Patrice Cacoub, Cristina Mussini, Vincenzo Puro, Nicoletta Ladisa, Franco Maggiolo, Marco Rizzi, Leonardo Calza, Vincenzo Colangeli, Nicolò Girometti, Alice Ferraresi, Emanuele Focà, Pier Francesco Giorgetti, Maria Chiara Pezzoli, Benedetto Maurizio Celesia, Marilia Rita Pinzone, Tiziana BrunoAlberto Viada, Davide Vitullo, Viola Guardigni, Laura Sighinolfi, Silvia Ambu, Dario Bartolozzi, Irene Campolmi, Massimo Meli, Marco Pozzi, Gaetana Sterrantino, Filippo Matarazzo, Francesco Purificato, Enza Anzalone, Sarracino Luciano, Miriam Lichtner, Marocco Raffaella, Vito Sante Mercurio, Paula Castelli Lorena, Paoli Martorelli, Angela Linzalone, Franklyn Esoka, Eseme Enzo Raise, Simona Bossolasco, Antonella Castagna, Massimo Cernuschi, Paola Cinque, Luca Fumagalli, Giovanni Gaiera, Nicola Gianotti, Monica Guffanti, Miriam Maillard, Silvia Nozza, Vincenzo Spagnuolo, Caterina Uberti-Foppa, Vanni Borghi, Luchino Chessa, Laura Matta, Maria Cristina Pasetto, Giuseppe D'Esposito, Alfredo Franco, Crescenzo Maria Izzo, Elio Manzillo, Alessandro Marocco, Raffaele Micillo, Teresa Pizzella, Salvatore Martini, Maria Vittoria Moretti, Elisabetta Schiaroli, Corrado Catalani, Marina Giorgi, Beatrice Menichini, Michele Trezzi, Simona Migliore, Giuseppe Ballardini, Enrico Barchi, Elisa Garlassi, Giacomo Magnani, Francesca Prati, Lucia Testa, Maria Alessandra Ursitti, Giuliana Zoboli, Elisabetta Teti, Anna Rita Buonomini, Carlotta Cerva, D'Anna Giovanni D'Anna, Barbara Ilari, Vincenzo Malagnino, Loredana Sarmati, Adriana Ammassari, Rita Bellagamba, Boumis Evangelo, Stefania Cicalini, Giuseppina Liuzzi, Laura Loiacono, Paolo Migliorisi, Emanuele Nicastri, Carmela Pinnetti, Alessandro Sampaolesi, Chiara Tommasi, Mauro Zaccarelli, Rosalia Angileri, Maria Coscia, Gabriella d'Ettorre, Alessandra Fantauzzi, Giancarlo Iaiani, Ivano Mezzaroma, Francesca Paoletti, Maria Zaccaria, Andrea De Luca, Barbara Rossetti, Manola Pomi, Nicoletta Carnicelli, Angela Gonnelli, Daniele Marri, Lucia Toscano, Orlando Armignacco, Anna Rita Caterini, Antonio Luciano Caterini, Barbara Di Filippo, Anna Maria Ialungo, Elena Rastrelli, Rita Sabatini

Division of Infectious Diseases

Research output: Contribution to journal › Article › peer-review

5 Scopus citations

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.

Original language	English
Article number	734
Journal	BMC Infectious Diseases
Volume	17
Issue number	1
DOIs	https://doi.org/10.1186/s12879-017-2819-5
State	Published - Nov 28 2017

Keywords

Anti-HIV agents
HIV physicians
HIV prevention
Persons Living with HIV/AIDS (PLWHA)
Pre-Exposure Prophylaxis (PrEP)

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The PrEPventHIV Italy Study Group, Palummieri, A., De Carli, G., Rosenthal, É., Cacoub, P., Mussini, C., Puro, V., Ladisa, N., Maggiolo, F., Rizzi, M., Calza, L., Colangeli, V., Girometti, N., Ferraresi, A., Focà, E., Giorgetti, P. F., Pezzoli, M. C., Celesia, B. M., Pinzone, M. R., ... Sabatini, R. (2017). 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. BMC Infectious Diseases, 17(1), Article 734. https://doi.org/10.1186/s12879-017-2819-5

@article{ddbdb6611d834bfb866a40c28a85f93b,

title = "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",

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.",

keywords = "Anti-HIV agents, HIV physicians, HIV prevention, Persons Living with HIV/AIDS (PLWHA), Pre-Exposure Prophylaxis (PrEP)",

author = "{The PrEPventHIV Italy Study Group} and Antonio Palummieri and {De Carli}, Gabriella and {\'E}ric Rosenthal and Patrice Cacoub and Cristina Mussini and Vincenzo Puro and Nicoletta Ladisa and Franco Maggiolo and Marco Rizzi and Leonardo Calza and Vincenzo Colangeli and Nicol{\`o} Girometti and Alice Ferraresi and Emanuele Foc{\`a} and Giorgetti, {Pier Francesco} and Pezzoli, {Maria Chiara} and Celesia, {Benedetto Maurizio} and Pinzone, {Marilia Rita} and Tiziana Bruno and Alberto Viada and Davide Vitullo and Viola Guardigni and Laura Sighinolfi and Silvia Ambu and Dario Bartolozzi and Irene Campolmi and Massimo Meli and Marco Pozzi and Gaetana Sterrantino and Filippo Matarazzo and Francesco Purificato and Enza Anzalone and Sarracino Luciano and Miriam Lichtner and Marocco Raffaella and Mercurio, {Vito Sante} and Lorena, {Paula Castelli} and Paoli Martorelli and Angela Linzalone and Franklyn Esoka and Raise, {Eseme Enzo} and Simona Bossolasco and Antonella Castagna and Massimo Cernuschi and Paola Cinque and Luca Fumagalli and Giovanni Gaiera and Nicola Gianotti and Monica Guffanti and Miriam Maillard and Silvia Nozza and Vincenzo Spagnuolo and Caterina Uberti-Foppa and Vanni Borghi and Luchino Chessa and Laura Matta and Pasetto, {Maria Cristina} and Giuseppe D'Esposito and Alfredo Franco and Izzo, {Crescenzo Maria} and Elio Manzillo and Alessandro Marocco and Raffaele Micillo and Teresa Pizzella and Salvatore Martini and Moretti, {Maria Vittoria} and Elisabetta Schiaroli and Corrado Catalani and Marina Giorgi and Beatrice Menichini and Michele Trezzi and Simona Migliore and Giuseppe Ballardini and Enrico Barchi and Elisa Garlassi and Giacomo Magnani and Francesca Prati and Lucia Testa and Ursitti, {Maria Alessandra} and Giuliana Zoboli and Elisabetta Teti and Buonomini, {Anna Rita} and Carlotta Cerva and {Giovanni D'Anna}, D'Anna and Barbara Ilari and Vincenzo Malagnino and Loredana Sarmati and Adriana Ammassari and Rita Bellagamba and Boumis Evangelo and Stefania Cicalini and Giuseppina Liuzzi and Laura Loiacono and Paolo Migliorisi and Emanuele Nicastri and Carmela Pinnetti and Alessandro Sampaolesi and Chiara Tommasi and Mauro Zaccarelli and Rosalia Angileri and Maria Coscia and Gabriella d'Ettorre and Alessandra Fantauzzi and Giancarlo Iaiani and Ivano Mezzaroma and Francesca Paoletti and Maria Zaccaria and {De Luca}, Andrea and Barbara Rossetti and Manola Pomi and Nicoletta Carnicelli and Angela Gonnelli and Daniele Marri and Lucia Toscano and Orlando Armignacco and Caterini, {Anna Rita} and Caterini, {Antonio Luciano} and {Di Filippo}, Barbara and Ialungo, {Anna Maria} and Elena Rastrelli and Rita Sabatini",

note = "Publisher Copyright: {\textcopyright} 2017 The Author(s).",

year = "2017",

month = nov,

day = "28",

doi = "10.1186/s12879-017-2819-5",

language = "English",

volume = "17",

journal = "BMC Infectious Diseases",

issn = "1471-2334",

number = "1",

}

The PrEPventHIV Italy Study Group, Palummieri, A, De Carli, G, Rosenthal, É, Cacoub, P, Mussini, C, Puro, V, Ladisa, N, Maggiolo, F, Rizzi, M, Calza, L, Colangeli, V, Girometti, N, Ferraresi, A, Focà, E, Giorgetti, PF, Pezzoli, MC, Celesia, BM, Pinzone, MR, Bruno, T, Viada, A, Vitullo, D, Guardigni, V, Sighinolfi, L, Ambu, S, Bartolozzi, D, Campolmi, I, Meli, M, Pozzi, M, Sterrantino, G, Matarazzo, F, Purificato, F, Anzalone, E, Luciano, S, Lichtner, M, Raffaella, M, Mercurio, VS, Lorena, PC, Martorelli, P, Linzalone, A, Esoka, F, Raise, EE, Bossolasco, S, Castagna, A, Cernuschi, M, Cinque, P, Fumagalli, L, Gaiera, G, Gianotti, N, Guffanti, M, Maillard, M, Nozza, S, Spagnuolo, V, Uberti-Foppa, C, Borghi, V, Chessa, L, Matta, L, Pasetto, MC, D'Esposito, G, Franco, A, Izzo, CM, Manzillo, E, Marocco, A, Micillo, R, Pizzella, T, Martini, S, Moretti, MV, Schiaroli, E, Catalani, C, Giorgi, M, Menichini, B, Trezzi, M, Migliore, S, Ballardini, G, Barchi, E, Garlassi, E, Magnani, G, Prati, F, Testa, L, Ursitti, MA, Zoboli, G, Teti, E, Buonomini, AR, Cerva, C, Giovanni D'Anna, DA, Ilari, B, Malagnino, V, Sarmati, L, Ammassari, A, Bellagamba, R, Evangelo, B, Cicalini, S, Liuzzi, G, Loiacono, L, Migliorisi, P, Nicastri, E, Pinnetti, C, Sampaolesi, A, Tommasi, C, Zaccarelli, M, Angileri, R, Coscia, M, d'Ettorre, G, Fantauzzi, A, Iaiani, G, Mezzaroma, I, Paoletti, F, Zaccaria, M, De Luca, A, Rossetti, B, Pomi, M, Carnicelli, N, Gonnelli, A, Marri, D, Toscano, L, Armignacco, O, Caterini, AR, Caterini, AL, Di Filippo, B, Ialungo, AM, Rastrelli, E & Sabatini, R 2017, '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', BMC Infectious Diseases, vol. 17, no. 1, 734. https://doi.org/10.1186/s12879-017-2819-5

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. / The PrEPventHIV Italy Study Group; Palummieri, Antonio; De Carli, Gabriella et al.
In: BMC Infectious Diseases, Vol. 17, No. 1, 734, 28.11.2017.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Awareness, discussion and non-prescribed use of HIV pre-exposure prophylaxis among persons living with HIV/AIDS in Italy

T2 - A Nationwide, cross-sectional study among patients on antiretrovirals and their treating HIV physicians

AU - The PrEPventHIV Italy Study Group

AU - Palummieri, Antonio

AU - De Carli, Gabriella

AU - Rosenthal, Éric

AU - Cacoub, Patrice

AU - Mussini, Cristina

AU - Puro, Vincenzo

AU - Ladisa, Nicoletta

AU - Maggiolo, Franco

AU - Rizzi, Marco

AU - Calza, Leonardo

AU - Colangeli, Vincenzo

AU - Girometti, Nicolò

AU - Ferraresi, Alice

AU - Focà, Emanuele

AU - Giorgetti, Pier Francesco

AU - Pezzoli, Maria Chiara

AU - Celesia, Benedetto Maurizio

AU - Pinzone, Marilia Rita

AU - Bruno, Tiziana

AU - Viada, Alberto

AU - Vitullo, Davide

AU - Guardigni, Viola

AU - Sighinolfi, Laura

AU - Ambu, Silvia

AU - Bartolozzi, Dario

AU - Campolmi, Irene

AU - Meli, Massimo

AU - Pozzi, Marco

AU - Sterrantino, Gaetana

AU - Matarazzo, Filippo

AU - Purificato, Francesco

AU - Anzalone, Enza

AU - Luciano, Sarracino

AU - Lichtner, Miriam

AU - Raffaella, Marocco

AU - Mercurio, Vito Sante

AU - Lorena, Paula Castelli

AU - Martorelli, Paoli

AU - Linzalone, Angela

AU - Esoka, Franklyn

AU - Raise, Eseme Enzo

AU - Bossolasco, Simona

AU - Castagna, Antonella

AU - Cernuschi, Massimo

AU - Cinque, Paola

AU - Fumagalli, Luca

AU - Gaiera, Giovanni

AU - Gianotti, Nicola

AU - Guffanti, Monica

AU - Maillard, Miriam

AU - Nozza, Silvia

AU - Spagnuolo, Vincenzo

AU - Uberti-Foppa, Caterina

AU - Borghi, Vanni

AU - Chessa, Luchino

AU - Matta, Laura

AU - Pasetto, Maria Cristina

AU - D'Esposito, Giuseppe

AU - Franco, Alfredo

AU - Izzo, Crescenzo Maria

AU - Manzillo, Elio

AU - Marocco, Alessandro

AU - Micillo, Raffaele

AU - Pizzella, Teresa

AU - Martini, Salvatore

AU - Moretti, Maria Vittoria

AU - Schiaroli, Elisabetta

AU - Catalani, Corrado

AU - Giorgi, Marina

AU - Menichini, Beatrice

AU - Trezzi, Michele

AU - Migliore, Simona

AU - Ballardini, Giuseppe

AU - Barchi, Enrico

AU - Garlassi, Elisa

AU - Magnani, Giacomo

AU - Prati, Francesca

AU - Testa, Lucia

AU - Ursitti, Maria Alessandra

AU - Zoboli, Giuliana

AU - Teti, Elisabetta

AU - Buonomini, Anna Rita

AU - Cerva, Carlotta

AU - Giovanni D'Anna, D'Anna

AU - Ilari, Barbara

AU - Malagnino, Vincenzo

AU - Sarmati, Loredana

AU - Ammassari, Adriana

AU - Bellagamba, Rita

AU - Evangelo, Boumis

AU - Cicalini, Stefania

AU - Liuzzi, Giuseppina

AU - Loiacono, Laura

AU - Migliorisi, Paolo

AU - Nicastri, Emanuele

AU - Pinnetti, Carmela

AU - Sampaolesi, Alessandro

AU - Tommasi, Chiara

AU - Zaccarelli, Mauro

AU - Angileri, Rosalia

AU - Coscia, Maria

AU - d'Ettorre, Gabriella

AU - Fantauzzi, Alessandra

AU - Iaiani, Giancarlo

AU - Mezzaroma, Ivano

AU - Paoletti, Francesca

AU - Zaccaria, Maria

AU - De Luca, Andrea

AU - Rossetti, Barbara

AU - Pomi, Manola

AU - Carnicelli, Nicoletta

AU - Gonnelli, Angela

AU - Marri, Daniele

AU - Toscano, Lucia

AU - Armignacco, Orlando

AU - Caterini, Anna Rita

AU - Caterini, Antonio Luciano

AU - Di Filippo, Barbara

AU - Ialungo, Anna Maria

AU - Rastrelli, Elena

AU - Sabatini, Rita

PY - 2017/11/28

Y1 - 2017/11/28

N2 - 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.

AB - 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.

KW - Anti-HIV agents

KW - HIV physicians

KW - HIV prevention

KW - Persons Living with HIV/AIDS (PLWHA)

KW - Pre-Exposure Prophylaxis (PrEP)

UR - http://www.scopus.com/inward/record.url?scp=85035141315&partnerID=8YFLogxK

U2 - 10.1186/s12879-017-2819-5

DO - 10.1186/s12879-017-2819-5

M3 - Article

C2 - 29179700

AN - SCOPUS:85035141315

SN - 1471-2334

VL - 17

JO - BMC Infectious Diseases

JF - BMC Infectious Diseases

IS - 1

M1 - 734

ER -

The PrEPventHIV Italy Study Group, Palummieri A, De Carli G, Rosenthal É, Cacoub P, Mussini C et al. 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. BMC Infectious Diseases. 2017 Nov 28;17(1):734. doi: 10.1186/s12879-017-2819-5

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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Keywords

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