Page 16 - EPREP book

PrEP clients
Most PrEP users are men who have sex with men (MSM), followed by transgender

women (TGW) and HIV-serodiscordant couples. A relatively higher proportion of serodiscordant

couples are found at hospital-based setting. Majority of PrEP clients have potential risk of HIV
infection due to sexual risk behaviors including having multiple partners and less/no condoms

use when having sexual intercourse while very few PrEP users reported of drug use or sharing
needle/syringe.

The most common reason to initiate PrEP was to protect themselves from HIV infection
apart from other prevention methods e.g. condom use. People who did not initiate PrEP after

being offered PrEP counseling service reported that they either did not have potential risk of

HIV infection or did not ready to take the medication and still had concern regarding drug
adverse effects. Those who discontinued PrEP were mainly due to having low or no potential

risk whereas individuals who ever stopped and restarted PrEP reported the reason as having

new potential risks for HIV infection. Majority of PrEP clients had good adherence with minimal
.
or no side effects Most adverse events occurred at starting of medication and were well
tolerated after taking PrEP continuously for a longer period.
The most frequent reasons for not initiating PrEP were their perceived with no or low

risk in acquiring HIV infection, followed by concerns or inconvenience about taking daily PrEP,
and adverse events.

The major reason for PrEP discontinuation was perceiving of no or low risk to HIV

infection. However, they showed willingness to restart PrEP again in the future if HIV risk
increased again. Other reasons included concerns regarding PrEP adverse events, and dislike

of medication taking and inconvenience of making an additional trip to the clinic.
There was no change in risk behavior regardless of PrEP use. Similar numbers of sexual

partners, frequency of condom use and STIs between prior and after PrEP initiation were

reported.
Majority of PrEP clients were most satisfied to PrEP service delivered at PrEP center.

However, regarding subjectively perceived convenience to access PrEP service, PrEP clients
from KPLHS seemed to have more convenience in accessing to service compared to those

from hospital-based setting

[xiii] รายงานการประเมินผล