Prevalence ratios comparing pooled HIV prevalence among men who engage in transactional sex to general population men aged 15 and older.

1<p>Among studies confirming HIV infection with a biological assay and among studies reporting ≥50 participants;</p>2<p>All prevalence ratios significant (<i>P</i><0.05) except for Bangladesh and Canada.</p><p>N = number of subjects; k = number of studies; I² = variation in pooled prevalence ratio due to heterogeneity; 95% CI = 95% Confidence Interval.</p

Participant Characteristics associated with Awareness of Pre-Exposure Prophylaxis (n = 642) One Month after Publication of Efficacy Results (the iPrEx Study).

<p>PrEP = pre-exposure prophylaxis; OR = odds ratio; CI = Confidence Interval; P = level of significance.</p><p>Variables that were not statistically significant in bivariate analyses and were not entered into the multivariable model include: number of male partners for unprotected anal intercourse (UAI) in the prior 3 months; self-perceived risk of HIV acquisition; monogamous status; race/ethnicity; health insurance coverage; UAI with ≥1 male partner, UAI with ≥5 male partners, UAI with ≥1 male partner who is HIV-infected or of unknown serostatus, transactional sex, UAI after ≥5 drinks, and UAI while using recreational drugs, each over the prior 3 months; identification of a primary care provider; diagnostic history of clinical depression; positive screen for depressive symptoms (Center for Epidemiologic Studies Scale); and prior treatment for drug or alcohol abuse. Variables that were not statistically significant in multivariable analyses include: interest in PrEP (likely or extremely likely to use PrEP); gender of sexual partners in prior 3 months; educational attainment; employment status; annual income; history of sexually transmitted infection; contact with any healthcare provider in the prior 12 months; among participants indicating UAI in the prior 3 months, having a primary care provider (PCP) who is aware of UAI behaviors; comfort discussing same-sex behaviors with PCP; having discussed ways to protect against HIV acquisition with PCP; and positive screen for alcohol abuse (4-item CAGE questionnaire).</p

Pooled HIV prevalence by HIV measurement and sample size.

<p>N = number of subjects; k = number of studies; 95% CI = 95% Confidence Interval.</p

Proportion of studies reporting individual factors that affect vulnerability to HIV by region, overall and specifically among men who engage in transactional sex.

1<p>Including syphilis, gonorrhea, chlamydia, human papilloma virus (HPV), and/or herpes simplex virus (HSV);</p>2<p>Risk factor reported among any population in the study (i.e., men who have sex with men);</p>3<p>Risk factor reported specifically among men who engage in transactional sex;</p>4<p>Fisher’s exact test comparing frequency of reporting factors by geographic region of study, overall and among men who report transactional sex.</p

Pooled HIV prevalence by country among studies reporting biologically-confirmed HIV prevalence with a sample size of ≥50 (N = 66).

<p>Pooled HIV prevalence by country among studies reporting biologically-confirmed HIV prevalence with a sample size of ≥50 (N = 66).</p

Participant Characteristics associated with Interest in Using Pre-Exposure Prophylaxis (n = 2 654) One Month after Publication of Efficacy Results (the iPrEx Study).

<p>PrEP = pre-exposure prophylaxis; OR = odds ratio; CI = Confidence Interval; P = level of significance; UAI = unprotected anal intercourse.</p>1<p>Interested in Using PrEP = likely or extremely likely to use PrEP.</p>2<p>Self-perceived risk of HIV acquisition = scale from 1 (no risk) to 10 (extreme risk).</p><p>Variables that were not statistically significant in bivariate analyses and were not entered into the multivariable model include: monogamous status; race/ethnicity; employment status; annual income; health insurance coverage; transactional sex, UAI after ≥5 drinks and UAI while using recreational drugs - each over the prior 3 months; history of sexually transmitted infection; prior PEP use; contact with any healthcare provider in prior 12 months; identification of a primary care provider (PCP); among participants indicating UAI in prior 3 months, having a PCP who is aware of UAI behaviors; diagnostic history of clinical depression; positive screen for depressive symptoms (Center for Epidemiologic Studies Scale); and prior treatment for drug or alcohol abuse. Variables that were not statistically significant in multivariable analyses include: number of male partners for UAI in the prior 3 months; awareness of PrEP; sexual orientation; gender of sexual partners in prior 3 months; educational attainment; UAI with ≥5 male partners and UAI with ≥1 male partner who is HIV-infected or of unknown serostatus - each over the prior 3 months; comfort discussing same-sex behaviors with PCP; having discussed ways to protect against HIV acquisition with PCP; and positive screen for alcohol abuse (4-item CAGE questionnaire).</p

Sociodemographic and Behavioral Characteristics of Study Participants Two Months before (n = 398) versus One Month after (n = 4 558) Publication of Oral Pre-Exposure Prophylaxis Efficacy Results (the iPrEx Study).

<p>UAI = unprotected anal intercourse; STI = sexually transmitted infection; PCP = primary care provider; CES-D = Center for Epidemiologic Studies Depression Scale; CAGE = 4-question screen for alcohol abuse.</p>1<p>Total number of participants responding to each question.</p>2<p>Self-perceived risk of HIV acquisition = scale from 1 (no risk) to 10 (extreme risk).</p>3<p>Interested in using PrEP = likely or extremely likely to use PrEP.</p>4<p>Excludes 15/2977 (0.5%) participants who self-identified as heterosexual post-iPrEx.</p>5<p>Among participants indicating UAI in the prior 3 months.</p

Participant Characteristics associated with Prior Use of Pre-Exposure Prophylaxis (n = 29) One Month after Publication of Efficacy Results (the iPrEx Study).

<p>OR = odds ratio; CI = Confidence Interval; P = level of significance; UAI = unprotected anal intercourse.</p><p>Variables that were not statistically significant in bivariate analyses and were not entered into the multivariable model include: age; self-perceived risk of HIV acquisition; self-identified sexual orientation; monogamous status; race/ethnicity; educational attainment; employment status; annual income; health insurance coverage; UAI with ≥1 male partner who is HIV-infected or of unknown serostatus, transactional sex, UAI after ≥5 drinks, and UAI while using recreational drugs - each over the prior 3 months; identification of a primary care provider (PCP); among participants indicating UAI in prior 3 months, having a PCP who is aware of UAI behaviors; comfort discussing same-sex behaviors with PCP; having discussed ways to protect against HIV acquisition with PCP; diagnostic history of clinical depression; positive screen for depressive symptoms (Center for Epidemiologic Studies Scale); positive screen for alcohol abuse (4-item CAGE questionnaire); and prior treatment for drug or alcohol abuse. Variables that were not statistically significant in multivariable analyses include: number of male partners for unprotected anal intercourse (UAI) and UAI with ≥5 male partners - each in the prior 3 months.</p

Flow diagram of included studies.

<p>Flow diagram of included studies.</p

Characteristics of Participants Reporting Use of Pre-Exposure Prophylaxis (n = 29) compared to Non-Users (n = 3 356) One Month after Publication of Efficacy Results (the iPrEx Study).

<p>UAI = unprotected anal intercourse; STI = sexually transmitted infection; PCP = primary care provider; CES-D = Center for Epidemiologic Studies Depression Scale; CAGE = 4-question screen for alcohol abuse.</p>*<p>P≤0.05,</p>**<p>P≤0.01 using test for difference between groups: t-test for continuous variables, chi-squared test or Fisher's exact test (when cell sizes are small) for categorical variables.</p>1<p>Total number of participants responding to each question.</p>2<p>Self-perceived risk of HIV acquisition = scale from 1 (no risk) to 10 (extreme risk).</p>3<p>Interested in using PrEP = likely or extremely likely to use PrEP.</p>4<p>Among participants indicating UAI in the prior 3 months.</p