Evidence map›Paper›PMID 31333200›Full record

ArticleJournal of medical Internet research2019

The PrEP You Want: A Web-Based Survey of Online Cross-Border Shopping for HIV Prophylaxis Medications.

Ben Walmsley, Dan Gallant, Mark Naccarato, Mark Hull, Alex Smith, Darrell Hoi-San Tan

Abstract read
In one paragraph

Article in Journal of medical Internet research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
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  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Ben WalmsleyDivision of Infectious Diseases, St Michael's Hospital, Toronto, ON, Canada.ORCID 0000-0003-2069-9632
Dan GallantGay Men's Sexual Health Alliance, Toronto, ON, Canada.ORCID 0000-0002-3660-4565
Mark NaccaratoDivision of Infectious Diseases, St Michael's Hospital, Toronto, ON, Canada.ORCID 0000-0001-5511-7415
Mark HullDivision of Infectious Diseases, University of British Columbia, Vancouver, BC, Canada.ORCID 0000-0002-9234-3531
Alex SmithCumming School of Medicine, University of Calgary, Calgary, AB, Canada.ORCID 0000-0002-3932-3873
Darrell Hoi-San TanDivision of Infectious Diseases, St Michael's Hospital, Toronto, ON, Canada.ORCID 0000-0002-3069-2875

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn response to the high cost of HIV pre-exposure prophylaxis (PrEP) medications in Canada, community organizations have created internet-based guides detailing how to legally order generic medications online and travel to collect them in the United States. However, little is known about the patients following these guides.

objectiveOur primary objective was to measure the proportion of Ontario gay, bisexual, and other men who have sex with men (GBMSM) accessing these online guides who intended to use the border-crossing approach. Our secondary objectives were to explore their demographic characteristics, their completion of the steps in the border-crossing approach, and the barriers they perceived.

methodsBetween July 20, 2017, and May 18, 2018, we administered two online surveys of GBMSM accessing an online border-crossing guide posted by a gay men's health organization in Ontario. Participants completed an open baseline survey posted on the border-crossing guide's Web page and a follow-up survey 3 months later. The data were analyzed using descriptive statistics. We used multivariable logistic regression to identify characteristics associated with the intention to use the border-crossing approach.

resultsMost of the 141 participants were young (median age 23, interquartile range 22-25 years) and black (79.4%; 112/141) GBMSM who had completed a college or an undergraduate degree (62.4%; 88/141). In addition, 19.9% (28/141) of them reported a total family income less than Can $30,000 and another 53.9% (76/141) reported income between Can $30,000 and Can $60,000. 54.6% (76/141) paid for medications entirely out of pocket. Most participants indicated that they were likely to complete a border-crossing approach: 80.1% (113/141) at baseline and 79.1% (87/110) at follow-up. The characteristics associated with the intention to use the approach included being black (adjusted odds ratio [aOR] 5.73, 95% CI 2.06-16.61), paying for medications out of pocket (aOR 5.18, 95% CI 1.82-17.04), and having a provider who was thought to be willing to prescribe PrEP (aOR 4.42, 95% CI 1.63-12.41). Comparing baseline and follow-up for the 110 participants who completed both surveys, 65.4% (72/110) and 80.0% (88/110) had discussed PrEP with a health care provider, 18.1% (20/110) and 25.4% (28/110) had obtained a PrEP prescription, and 8.2% (9/110) and 5.5% (6/110) had ordered medications to that mailbox, whereas only 1.0% (1/110) and 0.0% (0/110) had crossed the border to collect them at baseline and follow-up, respectively. Reported barriers included perceived concerns about the approach's legality (56.0%; 79/141), the security of personal health information (39.0%; 55/141), and the safety of online vendors (38.3%; 54/141).

conclusionsDespite high interest in pursuing an online border-crossing approach to get PrEP medications, such an approach may not be a viable option for PrEP scale-up among interested GBMSM because of logistical challenges and perceptions of safety and legitimacy.

Indexed as

AdultAnti-HIV AgentsHIV InfectionsHomosexuality, MaleHumansInternetMalePre-Exposure ProphylaxisSexual and Gender MinoritiesSurveys and QuestionnairesYoung AdultAnti-HIV Agentsgeneric antiretroviral drugsHIVmen who have sex with menonline medication shoppingpre-exposure prophylaxistenofovir disoproxil fumarate/emtricitabine

Identifiers

PMID31333200
PMCPMC6681640

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.