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Article ; Online: Needed: A Life Course Perspective on Maintaining Pre-exposure Prophylaxis Use.

Siegler, Aaron J

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

2021 Volume 72, Issue 3, Page(s) 386–387

MeSH term(s)	Anti-HIV Agents/therapeutic use ; Diagnostic Tests, Routine ; HIV ; HIV Infections/drug therapy ; HIV Infections/prevention & control ; Humans ; Pre-Exposure Prophylaxis ; United States
Chemical Substances	Anti-HIV Agents
Language	English
Publishing date	2021-01-26
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Comment
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1093/cid/ciaa040
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Article ; Online: Preexposure Prophylaxis Indication Criteria Underidentify Black and Latinx Persons and Require Revision.

Siegler, Aaron J

American journal of public health

2020 Volume 110, Issue 3, Page(s) 267–268

MeSH term(s)	African Americans ; Chicago ; HIV Infections ; Humans ; Illinois ; Pre-Exposure Prophylaxis
Language	English
Publishing date	2020-02-04
Publishing country	United States
Document type	Editorial ; Research Support, N.I.H., Extramural ; Comment
ZDB-ID	121100-6
ISSN	1541-0048 ; 0090-0036 ; 0002-9572
ISSN (online)	1541-0048
ISSN	0090-0036 ; 0002-9572
DOI	10.2105/AJPH.2019.305514
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Article ; Online: Alignment of PrEP use and sexual behavior over four months among men who have sex with men in the southern United States.

Jones, Jeb / Pampati, Sanjana / Siegler, Aaron J

AIDS and behavior

2022 Volume 26, Issue 10, Page(s) 3378–3385

Abstract: Unlike antiretrovirals for HIV treatment, pre-exposure prophylaxis (PrEP) does not require continual adherence to be fully effective; rather, PrEP adherence is important only in the context of episodes of sexual risk. Therefore, studies of PrEP adherence ...

Abstract	Unlike antiretrovirals for HIV treatment, pre-exposure prophylaxis (PrEP) does not require continual adherence to be fully effective; rather, PrEP adherence is important only in the context of episodes of sexual risk. Therefore, studies of PrEP adherence and persistence must incorporate contemporaneous measurement of sexual behavior. Short, frequent surveys of PrEP use and sexual behavior allow for the measurement of the alignment between PrEP use and sexual behavior. We assessed the feasibility of using biweekly PrEP use and sexual behavior questionnaires to measure adherence and persistence on PrEP over a period of four months. We also measured the alignment of PrEP use and condomless anal sex. PrEP-using MSM in the southern US were recruited using online advertisements. Participants completed a baseline survey followed by brief surveys every two weeks for 16 weeks to report their PrEP use and sexual behavior over the preceding two-week period. Study retention was high: 91% of participants completed the baseline and final survey and, overall, 86% of study surveys were completed. Self-reported PrEP adherence and persistence were high, but instances of PrEP non-adherence were observed to frequently overlap with episodes of condomless anal sex. The most prominent reasons cited for missing PrEP doses were being too busy, not having PrEP on hand, and not being sexually active. Completing short, biweekly surveys of PrEP use and sexual behavior is feasible and acceptable to MSM in the southern US. Future studies should investigate incorporating biomarker measurements to validate self-reported adherence.
MeSH term(s)	Anti-HIV Agents/therapeutic use ; HIV Infections/drug therapy ; HIV Infections/epidemiology ; HIV Infections/prevention & control ; Homosexuality, Male ; Humans ; Male ; Medication Adherence ; Pre-Exposure Prophylaxis ; Sexual Behavior ; Sexual and Gender Minorities ; Tenofovir/therapeutic use ; United States/epidemiology
Chemical Substances	Anti-HIV Agents ; Tenofovir (99YXE507IL)
Language	English
Publishing date	2022-04-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	1339885-4
ISSN	1573-3254 ; 1090-7165
ISSN (online)	1573-3254
ISSN	1090-7165
DOI	10.1007/s10461-022-03685-7
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Article ; Online: Demographic and behavioral characteristics of urban and non-urban PrEP-using MSM in the South.

Jones, Jeb / Pampati, Sanjana / Emrick, Kayla / Siegler, Aaron J

AIDS care

2022 Volume 34, Issue 11, Page(s) 1461–1464

Abstract: Pre-exposure prophylaxis (PrEP) is a highly effective HIV prevention intervention; however, most studies of PrEP adherence and persistence among men who have sex with men (MSM) have been conducted with MSM who live in urban areas. The experiences of PrEP- ...

Abstract	Pre-exposure prophylaxis (PrEP) is a highly effective HIV prevention intervention; however, most studies of PrEP adherence and persistence among men who have sex with men (MSM) have been conducted with MSM who live in urban areas. The experiences of PrEP-using MSM in non-urban areas might differ due to increased barriers to culturally competent care. We examined similarities and differences among urban and non-urban PrEP-using MSM in the southern United States, the region with the highest number of annual HIV diagnoses. We surveyed a total of 78 (
MeSH term(s)	Male ; Humans ; United States ; Homosexuality, Male ; HIV Infections/epidemiology ; HIV Infections/prevention & control ; HIV Infections/drug therapy ; Sexual and Gender Minorities ; Anti-HIV Agents/therapeutic use ; Pre-Exposure Prophylaxis/methods ; Demography
Chemical Substances	Anti-HIV Agents
Language	English
Publishing date	2022-06-08
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1012651-x
ISSN	1360-0451 ; 0954-0121
ISSN (online)	1360-0451
ISSN	0954-0121
DOI	10.1080/09540121.2022.2085864
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Article ; Online: Effects of mode of transportation on PrEP persistence among urban men who have sex with men.

Sharpe, J Danielle / Siegler, Aaron J / Sanchez, Travis H / Guest, Jodie L / Sullivan, Patrick S

AIDS care

2023 Volume 35, Issue 9, Page(s) 1411–1419

Abstract: Little is known about the effect of travel-related factors, such as mode of transportation, on retention in PrEP care, or PrEP persistence. We used data from the 2020 American Men's Internet Survey and conducted multilevel logistic regression to estimate ...

Abstract	Little is known about the effect of travel-related factors, such as mode of transportation, on retention in PrEP care, or PrEP persistence. We used data from the 2020 American Men's Internet Survey and conducted multilevel logistic regression to estimate the association between mode of transportation used for healthcare access and PrEP persistence among urban gay, bisexual, and other men who have sex with men (MSM) in the U.S. MSM using public transportation were less likely to report PrEP persistence (aOR: 0.51; 95% CI: 0.28-0.95) than MSM using private transportation. There were no significant associations between PrEP persistence and using active transportation (aOR: 0.67; 95% CI: 0.35-1.29) or multimodal transportation (aOR: 0.85; 95% CI: 0.51-1.43) compared to using private transportation. Transportation-related interventions and policies are needed to address structural barriers to accessing PrEP services and to improve PrEP persistence in urban areas.
MeSH term(s)	Male ; Humans ; Homosexuality, Male ; Sexual and Gender Minorities ; Travel ; HIV Infections/prevention & control ; Patient Acceptance of Health Care ; Pre-Exposure Prophylaxis ; Travel-Related Illness
Language	English
Publishing date	2023-05-26
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1012651-x
ISSN	1360-0451 ; 0954-0121
ISSN (online)	1360-0451
ISSN	0954-0121
DOI	10.1080/09540121.2023.2217375
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Article ; Online: Siegler et al. Respond.

Siegler, Aaron J / Bratcher, Anna / Weiss, Kevin M

American journal of public health

2020 Volume 110, Issue 1, Page(s) e3–e4

MeSH term(s)	Homosexuality, Male ; Humans ; Male ; Sexual and Gender Minorities ; United States
Language	English
Publishing date	2020-02-04
Publishing country	United States
Document type	Letter ; Research Support, N.I.H., Extramural ; Comment
ZDB-ID	121100-6
ISSN	1541-0048 ; 0090-0036 ; 0002-9572
ISSN (online)	1541-0048
ISSN	0090-0036 ; 0002-9572
DOI	10.2105/AJPH.2019.305402
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Article ; Online: Bringing HIV Self-Testing to Scale in the United States: a Review of Challenges, Potential Solutions, and Future Opportunities.

Steehler, Kevin / Siegler, Aaron J

Journal of clinical microbiology

2019 Volume 57, Issue 11

Abstract: HIV self-testing (HIVST) provides an at-home option to counter the barriers that patients face with testing performed in health care settings. HIVST has gradually increased in popularity in a time when social media and technology-based solutions are ... ...

Abstract	HIV self-testing (HIVST) provides an at-home option to counter the barriers that patients face with testing performed in health care settings. HIVST has gradually increased in popularity in a time when social media and technology-based solutions are preferred. In this paper, we consider the aspects of self-testing that merit its integration into HIV testing and prevention systems in the United States. Several elements favor self-testing for large-scale implementation, including ease of use, convenience, potential for integration with mobile health (mHealth), and availability for various modes of distribution. HIVST has a demonstrated ability to reach at-risk individuals who otherwise rarely test. The paradigm of self-testing, however, introduces new challenges, including lesser test performance relative to that in health care settings, nonstandard counseling following receipt of test results, and difficulty in providing linkage to care. After discussing the performance of oral fluid versus blood-based HIVST, we review data regarding acceptability of HIVST, offer insights into counseling and linkage to care for HIVST, and provide examples of novel applications of and future research directions for HIVST.
MeSH term(s)	Diagnostic Self Evaluation ; Female ; HIV Infections/diagnosis ; HIV Infections/prevention & control ; Health Plan Implementation/methods ; Health Plan Implementation/trends ; Homosexuality, Male ; Humans ; Male ; Mass Screening/methods ; Mass Screening/trends ; Mouth/virology ; Patient Acceptance of Health Care ; Public Health/methods ; Public Health/trends ; Reagent Kits, Diagnostic/standards ; Reagent Kits, Diagnostic/statistics & numerical data ; United States
Chemical Substances	Reagent Kits, Diagnostic
Language	English
Publishing date	2019-10-23
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	390499-4
ISSN	1098-660X ; 0095-1137
ISSN (online)	1098-660X
ISSN	0095-1137
DOI	10.1128/JCM.00257-19
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Article ; Online: Law Everywhere: A Causal Framework for Law and Infectious Disease.

Siegler, Aaron J / Komro, Kelli A / Wagenaar, Alexander C

Public health reports (Washington, D.C. : 1974)

2020 Volume 135, Issue 1_suppl, Page(s) 25S–31S

MeSH term(s)	Communicable Disease Control/legislation & jurisprudence ; Health Behavior ; Health Equity/legislation & jurisprudence ; Health Policy/legislation & jurisprudence ; Hepatitis/prevention & control ; Humans ; Public Health/legislation & jurisprudence ; Sexually Transmitted Diseases/prevention & control ; Social Determinants of Health/legislation & jurisprudence ; Socioeconomic Factors ; Tuberculosis/prevention & control
Language	English
Publishing date	2020-05-04
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	120953-x
ISSN	1468-2877 ; 0033-3549
ISSN (online)	1468-2877
ISSN	0033-3549
DOI	10.1177/0033354920912991
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Article: Getting pre-exposure prophylaxis (PrEP) to the people: opportunities, challenges and emerging models of PrEP implementation.

Sullivan, Patrick S / Siegler, Aaron J

Sexual health

2018 Volume 15, Issue 6, Page(s) 522–527

Abstract: Pre-exposure prophylaxis (PrEP) with tenofovir disoproxil fumarate and emtricitabine (TDF/FTC) is now accepted as an efficacious approach to preventing HIV acquisition among people at high risk of HIV infection but, in most places, PrEP uptake to date ... ...

Abstract	Pre-exposure prophylaxis (PrEP) with tenofovir disoproxil fumarate and emtricitabine (TDF/FTC) is now accepted as an efficacious approach to preventing HIV acquisition among people at high risk of HIV infection but, in most places, PrEP uptake to date has not been sufficient to have a large effect on HIV incidence. In this paper we consider several key elements of the effort to expand PrEP uptake for at-risk populations who would benefit most, such as increasing access to PrEP, integrating PrEP programs with other services, promoting PrEP persistence and developing systems for monitoring PrEP use. We used a PrEP Continuum framework to describe barriers to equitable uptake of PrEP, and to illustrate possible solutions to barriers. Access to PrEP includes regulatory issues and geographic proximity to PrEP providers. Integrating PrEP programs with other comprehensive sexual health services, through clinic-based programs or technology-based approaches, offers opportunities to identify PrEP candidates and improve linkages to PrEP care. Once at-risk people are prescribed PrEP, lowering barriers to persistence on PrEP is critical to realising the most population benefits. To understand progress and identify underserved groups and communities, systems to monitor the uptake of PrEP are needed. Making the most of a new biomedical intervention tool requires ongoing research about implementation, scale-up through multiple channels, including community-based organisations, and high-quality monitoring of uptake. We must turn to questions of PrEP implementation and continue to seek innovative approaches to reduce barriers to PrEP uptake and persistence on PrEP.
MeSH term(s)	Administration, Oral ; Anti-HIV Agents/administration & dosage ; Emtricitabine/administration & dosage ; HIV Infections/prevention & control ; Health Equity ; Health Services Accessibility ; Humans ; Pre-Exposure Prophylaxis ; Tenofovir/administration & dosage
Chemical Substances	Anti-HIV Agents ; Tenofovir (99YXE507IL) ; Emtricitabine (G70B4ETF4S)
Language	English
Publishing date	2018-11-28
Publishing country	Australia
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, P.H.S. ; Review
ZDB-ID	2256731-8
ISSN	1449-8987 ; 1448-5028
ISSN (online)	1449-8987
ISSN	1448-5028
DOI	10.1071/SH18103
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Article ; Online: Changes in Sexual Behavior, PrEP Adherence, and Access to Sexual Health Services Because of the COVID-19 Pandemic Among a Cohort of PrEP-Using MSM in the South.

Pampati, Sanjana / Emrick, Kayla / Siegler, Aaron J / Jones, Jeb

Journal of acquired immune deficiency syndromes (1999)

2021 Volume 87, Issue 1, Page(s) 639–643

Abstract: Background: The coronavirus disease 2019 (COVID-19) pandemic has had unforeseen consequences on the delivery of HIV and sexually transmitted disease (STD) prevention services. However, little is known about how the pandemic has impacted pre-exposure ... ...

Abstract	Background: The coronavirus disease 2019 (COVID-19) pandemic has had unforeseen consequences on the delivery of HIV and sexually transmitted disease (STD) prevention services. However, little is known about how the pandemic has impacted pre-exposure prophylaxis (PrEP)-using men who have sex with men (MSM). Methods: Data come from an online cohort of PrEP-using MSM in the Southern United States from October 2019 to July 2020. Participants were administered 10 surveys in total, including 1 ad hoc survey specifically on COVID-19. We conducted a cross-sectional analysis of this ad hoc survey (n = 56) and present changes in sexual behaviors and utilization of and access to sexual health services. Using linear mixed-effect regression models, we also analyzed data from the larger cohort and document how sexual behaviors and PrEP use varied longitudinally across several months. Results: A fifth of participants discontinued or changed how often they take PrEP because of COVID-19. A quarter of the cohort documented challenges when attempting to access PrEP, HIV testing, or STD testing. For all sexual behaviors examined longitudinally-number of male sexual partners, anal sex acts, condomless anal sex, and oral sex (all measured in the past 2 weeks)-there was a decrease from February to April followed by an increase from April to June. Discussion: Our findings suggest reduced access to and utilization of STD and HIV services coupled with a continuation of behaviors which confer STD/HIV risk. Ensuring appropriate delivery of STD/HIV prevention services during this pandemic is imperative.
MeSH term(s)	Adolescent ; Adult ; Anti-HIV Agents/therapeutic use ; COVID-19/epidemiology ; Cohort Studies ; Cross-Sectional Studies ; HIV Infections/drug therapy ; Homosexuality, Male/statistics & numerical data ; Humans ; Longitudinal Studies ; Male ; Medication Adherence ; Pandemics ; Pre-Exposure Prophylaxis/statistics & numerical data ; SARS-CoV-2/isolation & purification ; Safe Sex ; Sexual Behavior/statistics & numerical data ; Sexual and Gender Minorities/statistics & numerical data ; Surveys and Questionnaires ; United States/epidemiology ; Young Adult
Chemical Substances	Anti-HIV Agents
Language	English
Publishing date	2021-01-28
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	645053-2
ISSN	1944-7884 ; 1077-9450 ; 0897-5965 ; 0894-9255 ; 1525-4135
ISSN (online)	1944-7884 ; 1077-9450
ISSN	0897-5965 ; 0894-9255 ; 1525-4135
DOI	10.1097/QAI.0000000000002640
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