Evidence map›Paper›PMID 25065857›Full record

ArticleThe Lancet. Infectious diseases2014

Uptake of pre-exposure prophylaxis, sexual practices, and HIV incidence in men and transgender women who have sex with men: a cohort study.

Robert M Grant, Peter L Anderson, Vanessa McMahan, Albert Liu, K Rivet Amico, Megha Mehrotra, Sybil Hosek, Carlos Mosquera, Martin Casapia, Orlando Montoya and 13 more

4 registry-linked trialsOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Lancet. Infectious diseases, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 795 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
795citing papers in PubMed, 12 pooled it
55.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02864550 phase4completednot on this mapstarted 2019, after this paper: background citation

A Randomized, Placebo-controlled Trial of Oral Doxycycline for the Prevention of Syphilis in HIV-positive Men Who Have Sex with Men (MSM)

TypeinterventionalSponsorBritish Columbia Centre for Disease ControlRan2019 to 2024Enrolled52ConditionsSyphilis, Sexually Transmitted InfectionsArmsDoxycycline, Placebo
NCT03617874 nacompletednot on this mapstarted 2020, after this paper: background citation

PC4PrEP: Integrating Pre-Exposure Prophylaxis (PrEP) Into Primary Care

TypeinterventionalSponsorAlbert Einstein College of MedicineRan2020 to 2022Enrolled22ConditionsHuman Immunodeficiency Virus TransmissionArmsPC4PrEP- Intervention Clinics, Standard of Care Clinics
NCT05044013 nacompletednot on this mapstarted 2023, after this paper: background citation

Training in mHealth Prevention With MSM

TypeinterventionalSponsorUniversity of ConnecticutRan2023 to 2025Enrolled90ConditionsHIV Prevention ProgramArmsFull access to JomPrEP app, inactivated JomPrEP app
NCT06860945 recruitingnot on this mapstarted 2025, after this paper: background citation

Development of a Predictive Model for Sexually Transmitted Infections in Individuals Using Pre-Exposure Prophylaxis for HIV in Spain

Typeobservational_patient_registrySponsorHospital Universitario de ValmeRan2025 to 2026Enrolled9,000ConditionsSexually Transmitted Infections (STIs), HIV, PrEPArmsNo Intervention: Observational Cohort
3 · Its place in the literature

Who cites it

795 citing papers in PubMed, 12 syntheses or guidelines pooled it, 1,239 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025
    Guideline
  4. Canadian guideline on HIV pre- and postexposure prophylaxis: 2025 update.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025
    Guideline
  5. Pooled it
  6. Antiretroviral Postexposure Prophylaxis After Sexual, Injection Drug Use, or Other Nonoccupational Exposure to HIV - CDC Recommendations, United States, 2025.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2025
    Guideline
  7. Pooled it
  8. Pooled it
  9. Pooled it
  10. Guideline
  11. Pooled it
  12. Pooled it
  13. Point-of-Care Urine Tenofovir Drug-Level Feedback Counseling Improves Long-Term Pre-exposure Prophylaxis Adherence for US Men Who Have Sex With Men in Pilot RCT.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026
    Trial
  14. Trial
  15. Trial
  16. Trial
  17. Trial
  18. Trial
  19. Trial
  20. Trial

735 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

23 authors at 12 institutions in 4 countries.

Robert M GrantGladstone Institutes, San Francisco, CA, USA; University of California, San Francisco, CA, USA; San Francisco AIDS Foundation, San Francisco, CA, USA. Electronic address: rgrant@gladstone.ucsf.edu.
Peter L AndersonUniversity of Colorado, Anschutz Medical Campus, Aurora, CO, USA.
Vanessa McMahanGladstone Institutes, San Francisco, CA, USA.
Albert LiuUniversity of California, San Francisco, CA, USA; San Francisco Department of Public Health, San Francisco, CA, USA.
K Rivet AmicoUniversity of Connecticut, Storr, CT, USA.
Megha MehrotraGladstone Institutes, San Francisco, CA, USA.
Sybil HosekStroger Hospital of Cook County, Chicago, IL, USA.
Carlos MosqueraINMENSA, Lima, Peru.
Martin CasapiaACSA, Iquitos, Peru.
Orlando MontoyaEquidad, Guayaquil, Ecuador.
Susan BuchbinderUniversity of California, San Francisco, CA, USA; San Francisco Department of Public Health, San Francisco, CA, USA.
Valdilea G VelosoFIOCRUZ, Rio de Janeiro, Brazil.
Kenneth MayerFenway Health, Boston, MA, USA.
Suwat ChariyalertsakUniversity of Chiang Mai, Chiang Mai, Thailand.
Linda-Gail BekkerDesmond Tutu Health Foundation, Cape Town, South Africa.
Esper G KallasUniversity of Sao Paulo, Sao Paulo, Brazil.
Mauro SchechterProjeto Praça Onze, Hospital Escola Sâo Francisco de Assis, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
Juan GuaniraINMENSA, Lima, Peru.
Lane BushmanUniversity of Colorado, Anschutz Medical Campus, Aurora, CO, USA.
David N BurnsNational Institutes of Health, Bethesda, MD, USA.
James F RooneyGilead Sciences, Foster City, CA, USA.
David V GliddenUniversity of California, San Francisco, CA, USA.
iPrEx study team
Gladstone Institutes · USUniversity of Colorado Anschutz Medical Campus · USChiang Mai University · THDesmond Tutu HIV Foundation · ZAFenway Health · USFundação Oswaldo Cruz · BRGilead Sciences (United States) · USJohn H. Stroger, Jr. Hospital of Cook County · USNational Institutes of Health · USUniversidade de São Paulo · BRUniversidade Federal do Rio de Janeiro · BRUniversity of California, San Francisco · US

Funding

Chemoprophylaxis for HIV Prevention in Men SupplementU01AI064002 · NIAID · J. DAVID GLADSTONE INSTITUTES · PI GRANT, ROBERT M. · 2005 to 2011
$41.3M
Chemoprophylaxis and HIV Host InteractionsR01AI118575 · NIAID · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI GRANT, ROBERT M. · 2015 to 2019
$2.9M
NIAID NIH HHS R01 AI118575NIAID NIH HHS U01 AI064002
6 · The paper itself

Abstract

backgroundThe effect of HIV pre-exposure prophylaxis (PrEP) depends on uptake, adherence, and sexual practices. We aimed to assess these factors in a cohort of HIV-negative people at risk of infection.

methodsIn our cohort study, men and transgender women who have sex with men previously enrolled in PrEP trials (ATN 082, iPrEx, and US Safety Study) were enrolled in a 72 week open-label extension. We measured drug concentrations in plasma and dried blood spots in seroconverters and a random sample of seronegative participants. We assessed PrEP uptake, adherence, sexual practices, and HIV incidence. Statistical methods included Poisson models, comparison of proportions, and generalised estimating equations.

findingsWe enrolled 1603 HIV-negative people, of whom 1225 (76%) received PrEP. Uptake was higher among those reporting condomless receptive anal intercourse (416/519 [81%] vs 809/1084 [75%], p=0·003) and having serological evidence of herpes (612/791 [77%] vs 613/812 [75%] p=0·03). Of those receiving PrEP, HIV incidence was 1·8 infections per 100 person-years, compared with 2·6 infections per 100 person-years in those who concurrently did not choose PrEP (HR 0·51, 95% CI 0·26-1·01, adjusted for sexual behaviours), and 3·9 infections per 100 person-years in the placebo group of the previous randomised phase (HR 0·49, 95% CI 0·31-0·77). Among those receiving PrEP, HIV incidence was 4·7 infections per 100 person-years if drug was not detected in dried blood spots, 2·3 infections per 100 person-years if drug concentrations suggested use of fewer than two tablets per week, 0·6 per 100 person-years for use of two to three tablets per week, and 0·0 per 100 person-years for use of four or more tablets per week (p<0·0001). PrEP drug concentrations were higher among people of older age, with more schooling, who reported non-condom receptive anal intercourse, who had more sexual partners, and who had a history of syphilis or herpes.

interpretationPrEP uptake was high when made available free of charge by experienced providers. The effect of PrEP is increased by greater uptake and adherence during periods of higher risk. Drug concentrations in dried blood spots are strongly correlated with protective benefit.

fundingUS National Institutes of Health.

Indexed as

Sexual BehaviorTransgender PersonsAdolescentAdultAnti-HIV AgentsCohort StudiesFemaleHIV InfectionsHumansIncidenceMaleAnti-HIV Agents

Identifiers

PMID25065857
PMCPMC6107918
OpenAlexW2150644408

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.