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Estimates of HIV pre-exposure prophylaxis (PrEP) coverage in the U.S. military, defined as the proportion of the persons taking HIV PrEP out of the estimated number of persons who had indications for it, have never been published. The objective of this study was to provide an estimate of HIV PrEP coverage comparable to U.S. civilian estimates. The population with indications for HIV PrEP was obtained from the Department of Defense 2018 Health Related Behaviors Survey, a stratified random sample of members of all military service branches. The military PrEP coverage estimate of 31.6% in 2023 was lower than the national U.S. estimate of 36.0% in 2022. Among the military population of men who have sex with men (MSM), an estimated 24.6% of service members had indications for PrEP, similar to the national estimate of 24.7%. MSM comprised 66% of all military service members with HIV PrEP indications, compared to 40% in the U.S. general population. The U.S. military should continue deliberate, sustained, and effective actions to address sexual health inequities among MSM, aligned and coordinated with societal efforts including improved coverage of HIV PrEP to prevent HIV transmission.
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Cult Health Sex
September 2025
Department of Behavioral and Social Sciences, Brown University, Providence, RI, USA.
Transgender women and sex workers in Brazil underutilise HIV prevention services. Understanding preferences and decision-making regarding HIV prevention can help develop new programmes to meet their needs. We conducted semi-structured interviews with 26 transgender women and travesti sex workers in São Paulo, Brazil.
View Article and Find Full Text PDFOpen Forum Infect Dis
September 2025
Department of Epidemiology, University of Washington, Seattle, Washington, USA.
Accurate point-of-care tools are needed to detect early nonadherence to daily HIV regimens and support timely transitions to long-acting options. Emerging evidence suggests that females may require higher adherence than males to achieve equivalent protection. Our next-generation urine tenofovir assay showed high accuracy across sexes but lower urine drug levels among female participants.
View Article and Find Full Text PDFPLoS Med
September 2025
University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America.
Background: Oral emtricitabine/tenofovir disoproxil fumarate (F/TDF) preexposure prophylaxis (PrEP) effectiveness against HIV acquisition highly depends on adherence. For men who have sex with men, a dosing study in the United States (US) population defined clinically meaningful tenofovir diphosphate (TFV-DP) thresholds in dried blood spots (DBS) based on the rounded 25th percentile for 2, 4, and 7 doses/week as 350, 700, and 1,250 fmol/punch. However, divergent efficacy results in the first generation randomized clinical trials of F/TDF PrEP among African women led to several hypotheses to question whether the pharmacology and adherence requirement for oral F/TDF PrEP may be different in cisgender women compared to what is already established for men.
View Article and Find Full Text PDFSex Transm Dis
September 2025
Division of General Internal Medicine, Department of Medicine, Albert Einstein College of Medicine, Montefiore Health System, Bronx, NY, USA.
Background: Men who have sex with men (MSM) and transgender women (TGW) are at elevated mpox risk; vaccination can greatly reduce that risk. We assessed mpox awareness and vaccine acceptability among MSM and TGW.
Methods: In 2022, hybrid-mode (offline/online) surveys were administered among 250 MSM and 251 TGW in Chennai, India.
BMJ Open
September 2025
Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Nairobi County, Kenya.
Introduction: Oral HIV pre-exposure prophylaxis (PrEP) is a highly effective biomedical intervention for HIV prevention, but its access and utilisation are challenging, especially in high-burden settings such as Kenya. For potential PrEP users, long delays and repeated consultations with several providers are obstacles to both PrEP uptake and continuation. The One-Stop PrEP Care project aims to promote the use of PrEP among clients in the health system and enhance client satisfaction by reducing the waiting time.
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