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Article ; Online: High mortality in adolescents and young adults with perinatally-acquired HIV in Thailand during the transition to adulthood.

Ounchanum, Pradthana / Aurpibul, Linda / Teeraananchai, Sirinya / Lumbiganon, Pagakrong / Songtaweesin, Wipaporn Natalie / Sudjaritruk, Tavitiya / Chokephaibulkit, Kulkanya / Rungmaitree, Supattra / Kosalaraksa, Pope / Suwanlerk, Tulathip / Ross, Jeremy L / Sohn, Annette H / Puthanakit, Thanyawee

AIDS care

2024 , Page(s) 1–10

Abstract: Transitioning from pediatric to adult care remains a challenge for adolescents and young adults with perinatally-acquired HIV (AYA-PHIV). We assessed treatment outcomes and mortality among Thai AYA-PHIV. The study included AYA-PHIV who reached age 18-24 ... ...

Abstract	Transitioning from pediatric to adult care remains a challenge for adolescents and young adults with perinatally-acquired HIV (AYA-PHIV). We assessed treatment outcomes and mortality among Thai AYA-PHIV. The study included AYA-PHIV who reached age 18-24 years who started antiretroviral treatment during childhood at five pediatric HIV clinics across Thailand. From November 2020-July 2021, data were gathered from a cohort database, medical records, and the Thai National AIDS Program. Of 811 eligible AYA-PHIV, 93% were alive; median age 22.3 years (IQR 20.6-23.7), treatment duration 16.1 years (IQR 13.4-18.0). Current HIV care was provided in adults (71%) and pediatric clinics (29%). Treatment regimens included non-nucleoside reverse transcriptase inhibitors (55%), protease inhibitors (36%), and integrase inhibitors (8%); 78% had HIV RNA <200 copies/ml. Of the 7.0% who died, median age at death was 20.8 years (IQR 20.6-22.1); 88% were AIDS-related death. Mortality after age 18 was 1.76 per 100-person years (95% confidence interval 1.36-2.28). Those with CD4 <200 cell/mm
Language	English
Publishing date	2024-03-06
Publishing country	England
Document type	Journal Article
ZDB-ID	1012651-x
ISSN	1360-0451 ; 0954-0121
ISSN (online)	1360-0451
ISSN	0954-0121
DOI	10.1080/09540121.2024.2325100
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Zs.A 2799: Show issues

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Article ; Online: Key population-led community-based same-day antiretroviral therapy (CB-SDART) initiation hub in Bangkok, Thailand: a protocol for a hybrid type 3 implementation trial.

Lujintanon, Sita / Amatavete, Sorawit / Thitipatarakorn, Supanat / Puthanakit, Thanyawee / Songtaweesin, Wipaporn Natalie / Chaisalee, Tanachai / Janyam, Surang / Phanuphak, Nittaya / Ramautarsing, Reshmie A

Implementation science communications

2022 Volume 3, Issue 1, Page(s) 101

Abstract: Background: Same-day antiretroviral therapy (SDART) initiation, in which people living with HIV (PLHIV) who are antiretroviral therapy (ART)-naïve, willing, and clinically eligible start ART on the same day of HIV diagnosis, has been implemented in ... ...

Abstract	Background: Same-day antiretroviral therapy (SDART) initiation, in which people living with HIV (PLHIV) who are antiretroviral therapy (ART)-naïve, willing, and clinically eligible start ART on the same day of HIV diagnosis, has been implemented in several healthcare facilities in Thailand since 2017. This evidence-based practice has demonstrated increased ART uptake, virologic suppression, and retention in care. However, linkage to care gaps exist in community-based organizations (CBOs) in Bangkok whereby as much as 20% of key populations (KP), mainly men who have sex with men and transgender women, living with HIV were lost to follow-up pre-ART initiation. To increase access to and uptake of ART among these populations, this study proposes that trained KP lay providers should lead community-based ART (CB-SDART) initiation service. This protocol describes the combined use of the Proctor's implementation outcome framework and the Consolidated Framework for Implementation Research to guide and evaluate the CB-SDART implementation. Methods: This study follows the hybrid design type 3: it is an implementation trial that secondarily assesses service and client outcomes by comparative interrupted time series analysis. Five strategies have been formulated to meet three implementation outcomes (i.e., feasibility, fidelity, and sustainability): (1) developing stakeholder relationships by engaging the CBO leaderships, (2) training and educating KP lay providers, (3) adapting and tailoring SDART to CBO-specific context, (4) using evaluative and iterative strategies to assess adherence to standard operating procedures, and (5) developing stakeholder relationships by engaging external stakeholders. Teleconsultation with physicians and ART home delivery will be integrated as another ART initiation option for clients and allow service provision during the COVID-19 pandemic. A mixed-method assessment will be conducted on key stakeholders and PLHIV diagnosed at two implementing CBOs, Rainbow Sky Association of Thailand and Service Workers in Group Foundation, in Bangkok, Thailand. Discussion: This implementation research may be the first to provide robust data at the implementation, service, and client levels to inform how to successfully task-shift SDART initiation service to trained KP lay providers and facilitate the expansion of CB-SDART in the future. Trial registration: This trial was registered with the Thai Clinical Trial Registry as TCTR20210709004 on July 9, 2021.
Language	English
Publishing date	2022-10-01
Publishing country	England
Document type	Journal Article
ISSN	2662-2211
ISSN (online)	2662-2211
DOI	10.1186/s43058-022-00352-9
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Article ; Online: Suicide prevention research is crucial to achieving health equity for people with HIV.

Liu, Yuming / Songtaweesin, Wipaporn Natalie / Tucker, Joesph D / Sohn, Annette H / Latkin, Carl A / Hall, Brian J

The lancet. HIV

2022 Volume 9, Issue 11, Page(s) e745–e746

MeSH term(s)	Humans ; Health Equity ; HIV Infections/drug therapy ; HIV Infections/prevention & control ; Suicide/prevention & control ; Health Services Research
Language	English
Publishing date	2022-10-05
Publishing country	Netherlands
Document type	Letter
ISSN	2352-3018
ISSN (online)	2352-3018
DOI	10.1016/S2352-3018(22)00296-X
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Article ; Online: Good performance of syphilis rapid diagnostic test kits among young key populations in Thailand.

Kamolrattana, Rujirek / Songtaweesin, Wipaporn Natalie / Suchartlikitwong, Pintip / Sophonphan, Jiratchaya / Moonwong, Juthamanee / Wongharn, Prissana / Khamthi, Sasiprapha / Sritammasiri, Taweesak / Puthanakit, Thanyawee / Anugulruengkitt, Suvaporn

International journal of STD & AIDS

2023 Volume 34, Issue 10, Page(s) 702–709

Abstract: Background: The prevalence of syphilis is increasing among adolescents and young adults (AYAs) globally. Use of syphilis rapid diagnostic treponemal tests (RDTs) may improve test coverage and same-day treatment. This study aims to determine sensitivity ... ...

Abstract	Background: The prevalence of syphilis is increasing among adolescents and young adults (AYAs) globally. Use of syphilis rapid diagnostic treponemal tests (RDTs) may improve test coverage and same-day treatment. This study aims to determine sensitivity and specificity of two syphilis RDTs. Methods: A cross-sectional study was conducted in men who have sex with men and transgender women aged 15-24 years attending a sexual health clinic in Bangkok. Syphilis RDTs used were Determine Syphilis TP and Bioline Syphilis 3.0, using whole blood from finger pricks and venipuncture. Results: From February to July 2022, 200 AYAs with a mean age 21.1 (SD2.1) years were enrolled, including 50 (25.0%) living with HIV. Prevalence of syphilis was 10.5% (95%CI 6.6-15.6), which was higher among AYAs living with HIV (22.0%) compared with AYAs unaffected by HIV (6.7%). Sensitivities of Determine Syphilis TP and Bioline Syphilis 3.0 were 85.7% (95%CI 63.7-97.0) and 66.7% (95%CI 43.0-85.4), respectively. Specificity of both RDTs was 100% (95%CI 98.0-100.0). Performance of RDTs was similar for both specimens. Conclusions: Syphilis RDTs have high sensitivity and specificity in diagnosing syphilis. It should be considered for use in sexual health clinics with high syphilis prevalence to initiate treatment promptly.
MeSH term(s)	Male ; Adolescent ; Young Adult ; Humans ; Female ; Adult ; Syphilis/diagnosis ; Syphilis/epidemiology ; Reagent Kits, Diagnostic ; Homosexuality, Male ; Syphilis Serodiagnosis ; Rapid Diagnostic Tests ; HIV Infections/diagnosis ; HIV Infections/epidemiology ; Thailand/epidemiology ; Cross-Sectional Studies ; Sexual and Gender Minorities ; Treponema pallidum ; Sensitivity and Specificity
Chemical Substances	Reagent Kits, Diagnostic
Language	English
Publishing date	2023-05-05
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1018089-8
ISSN	1758-1052 ; 0956-4624
ISSN (online)	1758-1052
ISSN	0956-4624
DOI	10.1177/09564624231174068
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Article ; Online: Adolescents with HIV and transition to adult care in the Caribbean, Central America and South America, Eastern Europe and Asia and Pacific regions.

Bailey, Heather / Cruz, Maria Letícia Santos / Songtaweesin, Wipaporn Natalie / Puthanakit, Thanyawee

Journal of the International AIDS Society

2017 Volume 20, Issue Suppl 3, Page(s) 21475

Abstract: Introduction: The HIV epidemics in the Caribbean, Central America and South America (CCASA), Eastern Europe (EE) and Asia and Pacific (AP) regions are diverse epidemics affecting different key populations in predominantly middle-income countries. This ... ...

Abstract	Introduction: The HIV epidemics in the Caribbean, Central America and South America (CCASA), Eastern Europe (EE) and Asia and Pacific (AP) regions are diverse epidemics affecting different key populations in predominantly middle-income countries. This narrative review describes the populations of HIV-positive youth approaching adolescence and adulthood in CCASA, EE and AP, what is known of their outcomes in paediatric and adult care to date, ongoing research efforts and future research priorities. Methods: We searched PubMed and abstracts from recent conferences and workshops using keywords including HIV, transition and adolescents, to identify published data on transition outcomes in CCASA, EE and AP. We also searched within our regional clinical/research networks for work conducted in this area and presented at local or national meetings. To give insight into future research priorities, we describe published data on characteristics and health status of young people as they approach age of transition, as a key determinant of health in early adulthood, and information available on current transition processes. Results and discussion: The perinatally HIV-infected populations in these three regions face a range of challenges including parental death and loss of family support; HIV-related stigma and socio-economic disparities; exposure to maternal injecting drug use; and late disclosure of HIV status. Behaviourally HIV-infected youth often belong to marginalized sub-groups, with particular challenges accessing services and care. Differences between and within countries in characteristics of HIV-positive youth and models of care need to be considered in comparisons of outcomes in young adulthood. The very little data published to date on transition outcomes across these three regions highlight some emerging issues around adherence, virological failure and loss to follow-up, alongside examples of programmes which have successfully supported adolescents to remain engaged with services and virologically suppressed. Conclusions: Limited data available indicate uneven outcomes in paediatric services and some shared challenges for adolescent transition including retention in care and adherence. The impact of issues specific to low prevalence, concentrated epidemic settings are poorly understood to date. Outcome data are urgently needed to guide management strategies and advocate for service provision in these regions.
MeSH term(s)	Adolescent ; Adult ; Biomedical Research ; Caribbean Region/epidemiology ; Central America/epidemiology ; Child ; Epidemics ; Europe, Eastern/epidemiology ; Female ; HIV Infections/epidemiology ; Health Status ; Humans ; Male ; Social Stigma ; South America/epidemiology ; Transition to Adult Care ; Young Adult
Language	English
Publishing date	2017--16
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2467110-1
ISSN	1758-2652 ; 1758-2652
ISSN (online)	1758-2652
ISSN	1758-2652
DOI	10.7448/IAS.20.4.21475
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Article ; Online: A Mobile Phone App to Support Adherence to Daily HIV Pre-exposure Prophylaxis Engagement Among Young Men Who Have Sex With Men and Transgender Women Aged 15 to 19 Years in Thailand: Pilot Randomized Controlled Trial.

Kawichai, Surinda / Songtaweesin, Wipaporn Natalie / Wongharn, Prissana / Phanuphak, Nittaya / Cressey, Tim R / Moonwong, Juthamanee / Vasinonta, Anuchit / Saisaengjan, Chutima / Chinbunchorn, Tanat / Puthanakit, Thanyawee

JMIR mHealth and uHealth

2022 Volume 10, Issue 4, Page(s) e25561

Abstract: Background: Widespread smartphone use provides opportunities for mobile health HIV prevention strategies among at-risk populations.: Objective: This study aims to investigate engagement in a theory-based (information-motivation-behavioral skills ... ...

Abstract	Background: Widespread smartphone use provides opportunities for mobile health HIV prevention strategies among at-risk populations. Objective: This study aims to investigate engagement in a theory-based (information-motivation-behavioral skills model) mobile phone app developed to support HIV pre-exposure prophylaxis (PrEP) adherence among Thai young men who have sex with men (YMSM) and young transgender women (YTGW) in Bangkok, Thailand. Methods: A randomized controlled trial was conducted among HIV-negative YMSM and YTGW aged 15-19 years initiating daily oral PrEP. Participants were randomized to receive either youth-friendly PrEP services (YFS) for 6 months, including monthly contact with site staff (clinic visits or telephone follow-up) and staff consultation access, or YFS plus use of a PrEP adherence support app (YFS+APP). The target population focus group discussion findings and the information-motivation-behavioral skills model informed app development. App features were based on the 3Rs-risk assessment of self-HIV acquisition risk, reminders to take PrEP, and rewards as redeemable points. Dried blood spots quantifying of tenofovir diphosphate were collected at months 3 and 6 to assess PrEP adherence. Tenofovir diphosphate ≥350-699 fmol/punch was classified as fair adherence and ≥700 fmol/punch as good adherence. Data analysis on app use paradata and exit interviews were conducted on the YFS+APP arm after 6 months of follow-up. Results: Between March 2018 and June 2019, 200 participants with a median age of 18 (IQR 17-19) years were enrolled. Overall, 74% (148/200) were YMSM; 87% (87/100) of participants who received YFS+APP logged in to the app and performed weekly HIV acquisition risk assessments (log-in and risk assessment [LRA]). The median duration between the first and last log-in was 3.5 (IQR 1.6-5.6) months, with a median frequency of 6 LRAs (IQR 2-10). Moreover, 22% (22/100) of the participants in the YFS+APP arm were frequent users (LRA≥10) during the 6-month follow-up period. YMSM were 9.3 (95% CI 1.2-74.3) times more likely to be frequent app users than YTGW (P=.04). Frequent app users had higher proportions (12%-16%) of PrEP adherence at both months 3 and 6 compared with infrequent users (LRA<10) and the YFS arm, although this did not reach statistical significance. Of the 100 participants in the YFS+APP arm, 23 (23%) were interviewed. The risk assessment function is perceived as the most useful app feature. Further aesthetic adaptations and a more comprehensive rewards system were suggested by the interviewees. Conclusions: Higher rates of PrEP adherence among frequent app users were observed; however, this was not statistically significant. A short app use duration of 3 months suggests that they may be useful in establishing habits in taking daily PrEP, but not long-term adherence. Further studies on the specific mechanisms of mobile phone apps that influence health behaviors are needed. Trial registration: ClinicalTrials.gov NCT03778892; https://clinicaltrials.gov/ct2/show/NCT03778892.
MeSH term(s)	Adolescent ; Adult ; Cell Phone ; Female ; HIV Infections/epidemiology ; HIV Infections/prevention & control ; Homosexuality, Male ; Humans ; Male ; Pilot Projects ; Pre-Exposure Prophylaxis ; Sexual and Gender Minorities ; Telephone ; Thailand ; Transgender Persons ; Young Adult
Language	English
Publishing date	2022-04-21
Publishing country	Canada
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	2719220-9
ISSN	2291-5222 ; 2291-5222
ISSN (online)	2291-5222
ISSN	2291-5222
DOI	10.2196/25561
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Article ; Online: Social Network Strategy to Promote HIV Testing and Linkage to HIV Services among Young men who Have sex with men and Transgender Women in Thailand.

Paiboon, Nantika / Songtaweesin, Wipaporn Natalie / Wongharn, Prissana / Moonwong, Jutamanee / Khamthi, Sasiprapha / Premgamone, Athiporn / Theerawit, Tuangtip / Saisaengjan, Chutima / Kawichai, Surinda / Anugulruengkitt, Suvaporn / Puthanakit, Thanyawee

Journal of the International Association of Providers of AIDS Care

2022 Volume 21, Page(s) 23259582221143672

Abstract: Background: ...

Abstract	Background:
MeSH term(s)	Adolescent ; Male ; Female ; Humans ; Young Adult ; Adult ; Homosexuality, Male ; Thailand/epidemiology ; HIV Infections/diagnosis ; HIV Infections/epidemiology ; HIV Infections/prevention & control ; Transgender Persons ; Sexual and Gender Minorities ; HIV Testing ; Social Networking
Language	English
Publishing date	2022-11-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	2709037-1
ISSN	2325-9582 ; 2325-9574
ISSN (online)	2325-9582
ISSN	2325-9574
DOI	10.1177/23259582221143672
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Article ; Online: Case Report: Simple Nodular Cutaneous Leishmaniasis Caused by Autochthonous Leishmania (Mundinia) orientalis in an 18-Month-Old Girl: The First Pediatric Case in Thailand and Literature Review.

Anugulruengkitt, Suvaporn / Songtaweesin, Wipaporn Natalie / Thepnarong, Nattawan / Tangthanapalakul, Amatanun / Sitthisan, Manassaya / Chatproedprai, Susheera / Wititsuwannakul, Jade / Likitnukul, Sasithorn / Jariyapan, Narissara / Weedall, Gareth D / Siriyasatien, Padet / Preativatanyou, Kanok

The American journal of tropical medicine and hygiene

2022 Volume 108, Issue 1, Page(s) 44–50

Abstract: We report an autochthonous case of simple, localized cutaneous leishmaniasis in a healthy 18-month-old girl from southern Thailand. The patient presented with a solitary chronic cutaneous nodular lesion on her left cheek for approximately 1 year. ... ...

Abstract	We report an autochthonous case of simple, localized cutaneous leishmaniasis in a healthy 18-month-old girl from southern Thailand. The patient presented with a solitary chronic cutaneous nodular lesion on her left cheek for approximately 1 year. Histopathological dissection of the cheek skin biopsy demonstrated remarkably nodular and interstitial infiltrates of lymphocytes and histiocytes full of intracellular oval-shaped amastigotes, consistent with cutaneous leishmaniasis. The Leishmania promastigotes were also cultured successfully from the lesion biopsy and were designated with the WHO code MHOM/TH/2021/CULE5. Using internal transcribed spacer 1-specific polymerase chain reaction, the parasite DNA was demonstrated in both saliva and lesion biopsy. Based on the BLASTn and phylogenetic analysis, the parasite was identified as Leishmania orientalis, clustered in the Mundinia subgenus. The patient responded well to a 6-week course of oral itraconazole, without recurrence. To our knowledge, this is the fourth case of autochthonous leishmaniasis resulting from L. orientalis and the youngest patient of leishmaniasis ever reported in Thailand. More importantly, we also demonstrate the clinical course of the lesion according to the timeline before and after treatment, which can help physicians better understand and provide an accurate diagnosis with appropriate treatment of this emerging parasitic disease.
MeSH term(s)	Humans ; Child ; Female ; Infant ; Leishmania/genetics ; Thailand ; Phylogeny ; Leishmaniasis, Cutaneous/diagnosis ; Leishmaniasis, Cutaneous/drug therapy ; Leishmaniasis, Cutaneous/pathology ; Skin/pathology
Language	English
Publishing date	2022-11-21
Publishing country	United States
Document type	Review ; Case Reports
ZDB-ID	2942-7
ISSN	1476-1645 ; 0002-9637
ISSN (online)	1476-1645
ISSN	0002-9637
DOI	10.4269/ajtmh.22-0385
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Ud II Zs.61: Show issues

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Article ; Online: Husband's willingness-to-pay for HIV and syphilis screening at antenatal care clinic under the Thai universal coverage scheme.

Anunsittichai, Orawan / Pongpirul, Krit / Puthanakit, Thanyawee / Roowicha, Koranit / Kaewprasert, Jirarat / Songtaweesin, Wipaporn Natalie / Chaithongwongwattana, Surasith

BMC public health

2020 Volume 20, Issue 1, Page(s) 480

Abstract: Background: Screening for sexually transmitted infection (STI) especially HIV as early detection and treatment have been financially supported under the Thai Universal Coverage (UC) scheme since 2009 (THB140 for HIV). However, the implementation has not ...

Abstract	Background: Screening for sexually transmitted infection (STI) especially HIV as early detection and treatment have been financially supported under the Thai Universal Coverage (UC) scheme since 2009 (THB140 for HIV). However, the implementation has not been evidence-based, strategic risk-based, nor economically evaluated whereas husbands who accompanied the pregnant women are likely to have a lower risk than those who did not come along. This study is aimed to determine the husband's willingness-to-pay (WTP) for his HIV and syphilis screening tests and potential factors affecting STI screenings at the antenatal care (ANC) clinic of a tertiary hospital in Thailand. Methods: A pilot open-ended interview was conducted among 50 participants to estimate the mean and standard deviation of WTP prices for HIV and syphilis screening tests. A questionnaire was developed to obtain demographics, STI knowledge and screening history, as well as two contingent valuation methods (bidding and payment scale), using the mean WTP prices identified from the pilot study as a starting WTP with ¼SD step-up/down. The survey of 200 randomly selected husbands of pregnant women was conducted at King Chulalongkorn Memorial Hospital from April to June 2018. Descriptive statistics and logistic regression were used for data analysis. Results: During the study period, 597 pregnant women received their first ANC. Of 368 accompanying husbands, 200 were enrolled in the study. Their median age was 31 (IQR 27-36) years old and 67% had a first child. Eighty-eight percent of the participants were willing to test for the STIs. Based on the bidding method, WTP prices for HIV and syphilis screening tests were US$14.5 (IQR 12.4-14.5) and US$9.7 (IQR 10-12), respectively. The payment scale method suggested approximately three-quarters of the WTP prices from the bidding method. Conclusions: The husbands who accompanied their pregnant wives to the ANC clinic showed positive behaviors according to the propitious selection theory. They tend to cooperate well with STI testing and are willing to pay at least two times the price of the STI screening tests. The financial support to promote STI screenings should be reconsidered to cover other groups with higher sexual behavior risks and less WTP.
MeSH term(s)	Adult ; Ambulatory Care Facilities ; Female ; Financing, Personal ; HIV Infections/prevention & control ; Humans ; Male ; Mass Screening/economics ; Pilot Projects ; Pregnancy ; Prenatal Care ; Spouses/psychology ; Spouses/statistics & numerical data ; Surveys and Questionnaires ; Syphilis/prevention & control ; Thailand ; Universal Health Insurance
Language	English
Publishing date	2020-04-10
Publishing country	England
Document type	Journal Article
ISSN	1471-2458
ISSN (online)	1471-2458
DOI	10.1186/s12889-020-08613-9
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Article ; Online: Effects of vitamin D and calcium supplementation on bone mineral density among Thai youth using daily HIV pre-exposure prophylaxis.

Pornpaisalsakul, Krittaporn / Songtaweesin, Wipaporn Natalie / Tepmongkol, Supatporn / Wongharn, Prissana / Kawichai, Surinda / Suponsilchai, Vichit / Anugulruengkitt, Suvaporn / Puthanakit, Thanyawee

Journal of the International AIDS Society

2020 Volume 23, Issue 10, Page(s) e25624

Abstract: Introduction: Tenofovir disoproxil fumarate with emtricitabine (TDF/FTC) is used for HIV pre-exposure prophylaxis (PrEP). TDF may affect bone mineral density (BMD), particularly in youth who are at a stage of peak bone mass accrual. The objective of ... ...

Abstract	Introduction: Tenofovir disoproxil fumarate with emtricitabine (TDF/FTC) is used for HIV pre-exposure prophylaxis (PrEP). TDF may affect bone mineral density (BMD), particularly in youth who are at a stage of peak bone mass accrual. The objective of this study was to evaluate the effect of vitamin D and calcium supplementation on BMD among Thai youth receiving daily oral PrEP. Methods: This open-label randomized trial was conducted in male youth aged between 15 and 24 years. Participants were randomized to Arm A who received once-daily TDF/FTC plus vitamin D3 and calcium supplementation with meals twice daily (400 units of vitamin D3 and 1200 mg of elemental calcium/day) or Arm B who received once-daily TDF/FTC only. PrEP users were defined as taking at least two tablets/week (tenofovir-diphosphate level of >350 fmol/punch). Adherence to vitamin D/calcium supplementation was defined as self-reported adherence of >50%. Lumbar spine (L2-L4) BMD (LSBMD) was evaluated by dual-energy X-ray absorptiometry scan zero and six months after PrEP initiation. Results: From March 2019 to March 2020, 100 youth were enrolled. Baseline characteristics between the two arms were similar. Median (IQR) age was 18 (17 to 20) years. At entry, median (IQR) LSBMD z-score was -0.8 (-1.5 to -0.3), 17% had low LSBMD (Z-score < -2). The median amount of calcium intake from nutritional three-day recall was 167 (IQR 94 to 272) mg/day, 39% of participants had vitamin D deficiency, defined as 25(OH)D levels <20 IU/mL. At six months, 79 participants were evaluated. Of these, 42 (52%) were PrEP takers and 25 of 38 (66%) of arm A participants had good adherence to vitamin D/calcium supplementation. Significantly higher proportions of youth in arm A compared to arm B had >3% increase in LSBMD at month 6 compared to baseline (67.6% vs. 42.9% respectively; p = 0.03). There were significantly higher increases in LSBMD among youth with vitamin D deficiency who were supplemented; arm A + 0.05 (0 to 0.05) compared to arm B + 0.03 (-0.1 to 0.03), p = 0.04. Conclusions: Increases in LSBMD over six months among youth using PrEP who received vitamin D/calcium supplementation was greater than those not supplemented. Long-term follow-up should be considered to explore long-term outcomes.
MeSH term(s)	Absorptiometry, Photon ; Adolescent ; Anti-HIV Agents/adverse effects ; Anti-HIV Agents/therapeutic use ; Bone Density/drug effects ; Calcium/administration & dosage ; Dietary Supplements ; Emtricitabine/therapeutic use ; HIV Infections/prevention & control ; Humans ; Male ; Pre-Exposure Prophylaxis ; Tenofovir/adverse effects ; Tenofovir/therapeutic use ; Thailand ; Vitamin D/administration & dosage ; Young Adult
Chemical Substances	Anti-HIV Agents ; Vitamin D (1406-16-2) ; Tenofovir (99YXE507IL) ; Emtricitabine (G70B4ETF4S) ; Calcium (SY7Q814VUP)
Language	English
Publishing date	2020-11-19
Publishing country	Switzerland
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	2467110-1
ISSN	1758-2652 ; 1758-2652
ISSN (online)	1758-2652
ISSN	1758-2652
DOI	10.1002/jia2.25624
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In stock of ZB MED Cologne/Königswinter

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Inter-library loan at ZB MED

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