Epidemiology Research Unit - Institute of Public Health, University of Porto

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Publications

Provision of Preexposure Prophylaxis at the Portuguese National Health Service and Uptake in the Lisbon Cohort of Men Who Have Sex with Men

Publication . Meireles, P.; Fernandes, F.; Rocha, Miguel; Plankey, M.; Barros, H.

We aimed to study the uptake of preexposure prophylaxis (PrEP) before and after its implementation in the Portuguese National Health Service (PNHS) among men who have sex with men (MSM). We studied 6164 participants in the Lisbon Cohort of MSM who participated between March 2014 and July 2019. 198 participants (3.2%) reported having recently used PrEP. Approximately one-third started PrEP after its implementation. PrEP uptake increased from 0.15% in 2014 to 5.36% in 2019. In their first use, 86 participants (70.5%) used it daily. How PrEP was obtained varied according to the timing of the first use: prescribed by a physician in Portugal (11.1% before vs 68.8% after implementation) and online (40.7% before vs 14.1% after). We observed an increase in the uptake and in the prescription by a physician, particularly after its implementation in the PNHS representing a change to a more equitable and safer way of using PrEP.

2021Journal article

Restricted access

Transitions Between Preexposure Prophylaxis Eligibility States and HIV Infection in The Lisbon Cohort of HIV-Negative Men Who Have Sex with Men: a Multistate Model Analysis

Publication . Meireles, Paula; Rocha, Miguel; Moreira, Carla; Plankey, Michael; Barros, Henrique

We aimed to describe transitions between preexposure prophylaxis (PrEP) eligibility and human immunodeficiency virus (HIV) infection among HIV-negative men who have sex with men (MSM). We used data from 1,885 MSM, who had not used PrEP, enrolled in the Lisbon Cohort of MSM, with at least 2 consecutive measurements of PrEP eligibility from 2014-2020. A time-homogeneous Markov multistate model was applied to describe the transitions between states of PrEP eligibility-eligible and ineligible-and from these to HIV infection (HIV). The intensities of the transitions were closer for ineligible-to-eligible and eligible-to-ineligible transitions (intensity ratio, 1.107, 95% confidence interval (CI): 1.080, 1.176), while the intensity of the eligible-to-HIV transition was higher than that for ineligible-to-HIV transition (intensity ratio, 9.558, 95% CI: 0.738, 65.048). The probabilities of transitions increased with time; for 90 days, the probabilities were similar for the ineligible-to-eligible and eligible-to-ineligible transitions (0.285 (95% CI: 0.252, 0.319) vs. 0.258 (95% CI: 0.228, 0.287)), while the eligible-to-HIV transition was more likely than ineligible-to-HIV (0.004 (95% CI: 0.003, 0.007) vs. 0.001 (95% CI: 0.001, 0.008)) but tended to become closer with time. Being classified as ineligible was a short-term indicator of a lower probability of acquiring HIV. Once an individual moved to eligible, he was at a higher risk of seroconversion, demanding a timely delivery ofPrEP.

2021-10-27Journal article

Open access

Bias-Motivated Physical or Verbal Violence Among Men Who Have Sex with Men: Findings from the Lisbon Cohort of MSM

Publication . Vieira, Laís; Fraga, Sílvia; Rocha, Miguel; Oliveira, Miguel; Meireles, Paula

2024Journal article

Open access