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2. Improving Hypertension Control in the Black Patient Population: A Quality Improvement Study of Workflow Redesign Using the Electronic Health Record to Integrate Self-Monitoring, Education, and Reporting.

Author

Duckie, Charmaine L., Boston, Karen A., Champagne, Brittney, Thompson, Julie, Halpern, David J., and Granger, Bradi B.

Subjects
HYPERTENSION, STATISTICAL power analysis, PATIENT participation, PATIENT portals, SELF-management (Psychology), SELF-evaluation, SYSTOLIC blood pressure, COMMUNITY health services, WORKFLOW, HEALTH literacy, HUMAN services programs, PRE-tests & post-tests, COMPARATIVE studies, T-test (Statistics), CONCEPTUAL structures, QUALITY assurance, DESCRIPTIVE statistics, ELECTRONIC health records, PATIENT education, HEALTH equity, DATA analysis software, AFRICAN Americans, EDUCATIONAL outcomes
Abstract

Background: Nearly half of American adults have hypertension (HTN), and non-Hispanic Black patients are diagnosed at a higher rate than others. Local Problem: Our local clinic population reflected disproportionate rates of uncontrolled HTN among Black patients. Methods: A quality improvement pre-/postintervention design was used to evaluate an educational intervention to reduce blood pressure (BP) and improve self-monitoring of BP in Black patients using the Chronic Care Model. Interventions: A team-based approach was used to redesign clinic workflows and patient education, prescribe self-paced videos from an electronic health record (EHR) patient portal, and provide home BP cuffs. Results: Black participants (n = 79) improved viewing of prescribed videos (7.9% to 68.5%), knowledge scores (67.9 to 75.2), and mean systolic BP (−20.3 mm Hg; P >.001). Conclusions: This team-based approach enhanced patient engagement, self-monitoring skills, EHR-reported BP, and overall BP control for a cohort of Black patients with uncontrolled BP. [ABSTRACT FROM AUTHOR]

Published
2024
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3. Teaching Unison Responding During Small-Group Direct Instruction to Students with Autism Spectrum Disorder Who Exhibit Interfering Behaviors

Author

Thompson, Julie L., Wood, Charles L., Preston, Angela, and Stevenson, Bradley

Subjects
Special education -- Methods, Special needs students -- Education, Task based instruction -- Methods, Educational research, Education, Teachers, Teaching, Autism, Education, Family and marriage, Social sciences
Abstract

Abstract Providing group instruction with high levels of opportunities to respond, including unison responding, is critical to maximize the educational instruction of individuals with autism spectrum disorders (ASD) in public [...]

Published
2019

4. sj-docx-5-rse-10.1177_07419325221143965 – Supplemental material for Culturally Adapted Social, Emotional, and Behavioral Support for Black Male Learners

Author

Campbell, Aaron Rachelle, Sallese, Mary Rose, Thompson, Julie L., Fournier, Constance J., and Allen, Meghan

Subjects
FOS: Psychology, 170199 Psychology not elsewhere classified, FOS: Educational sciences, 130312 Special Education and Disability, Education
Abstract

Supplemental material, sj-docx-5-rse-10.1177_07419325221143965 for Culturally Adapted Social, Emotional, and Behavioral Support for Black Male Learners by Aaron Rachelle Campbell, Mary Rose Sallese, Julie L. Thompson, Constance J. Fournier and Meghan Allen in Remedial and Special Education

Published
2023
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5. sj-docx-3-rse-10.1177_07419325221143965 – Supplemental material for Culturally Adapted Social, Emotional, and Behavioral Support for Black Male Learners

Author

Campbell, Aaron Rachelle, Sallese, Mary Rose, Thompson, Julie L., Fournier, Constance J., and Allen, Meghan

Subjects
FOS: Psychology, 170199 Psychology not elsewhere classified, FOS: Educational sciences, 130312 Special Education and Disability, Education
Abstract

Supplemental material, sj-docx-3-rse-10.1177_07419325221143965 for Culturally Adapted Social, Emotional, and Behavioral Support for Black Male Learners by Aaron Rachelle Campbell, Mary Rose Sallese, Julie L. Thompson, Constance J. Fournier and Meghan Allen in Remedial and Special Education

Published
2023
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6. sj-docx-4-rse-10.1177_07419325221143965 – Supplemental material for Culturally Adapted Social, Emotional, and Behavioral Support for Black Male Learners

Author

Campbell, Aaron Rachelle, Sallese, Mary Rose, Thompson, Julie L., Fournier, Constance J., and Allen, Meghan

Subjects
FOS: Psychology, 170199 Psychology not elsewhere classified, FOS: Educational sciences, 130312 Special Education and Disability, Education
Abstract

Supplemental material, sj-docx-4-rse-10.1177_07419325221143965 for Culturally Adapted Social, Emotional, and Behavioral Support for Black Male Learners by Aaron Rachelle Campbell, Mary Rose Sallese, Julie L. Thompson, Constance J. Fournier and Meghan Allen in Remedial and Special Education

Published
2023
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7. sj-docx-2-rse-10.1177_07419325221143965 – Supplemental material for Culturally Adapted Social, Emotional, and Behavioral Support for Black Male Learners

Author

Campbell, Aaron Rachelle, Sallese, Mary Rose, Thompson, Julie L., Fournier, Constance J., and Allen, Meghan

Subjects
FOS: Psychology, 170199 Psychology not elsewhere classified, FOS: Educational sciences, 130312 Special Education and Disability, Education
Abstract

Supplemental material, sj-docx-2-rse-10.1177_07419325221143965 for Culturally Adapted Social, Emotional, and Behavioral Support for Black Male Learners by Aaron Rachelle Campbell, Mary Rose Sallese, Julie L. Thompson, Constance J. Fournier and Meghan Allen in Remedial and Special Education

Published
2023
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8. sj-docx-1-rse-10.1177_07419325221143965 – Supplemental material for Culturally Adapted Social, Emotional, and Behavioral Support for Black Male Learners

Author

Campbell, Aaron Rachelle, Sallese, Mary Rose, Thompson, Julie L., Fournier, Constance J., and Allen, Meghan

Subjects
FOS: Psychology, 170199 Psychology not elsewhere classified, FOS: Educational sciences, 130312 Special Education and Disability, Education
Abstract

Supplemental material, sj-docx-1-rse-10.1177_07419325221143965 for Culturally Adapted Social, Emotional, and Behavioral Support for Black Male Learners by Aaron Rachelle Campbell, Mary Rose Sallese, Julie L. Thompson, Constance J. Fournier and Meghan Allen in Remedial and Special Education

Published
2023
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9. Mediating access to Headsprout.sup.® early reading for children with autism spectrum disorders

Author

Plavnick, Joshua B., Thompson, Julie L., Englert, Carol Sue, Mariage, Troy, and Johnson, Katie

Subjects
Computer assisted instruction -- Research, Early literacy -- Research, Autistic children -- Education, Pervasive developmental disorders -- Educational aspects -- Research, Education
Abstract

Many children with autism spectrum disorder (ASD) require instructional programs that simultaneously address academic content, interfering behavior, and potential gaps in prerequisite skills for a given curriculum. This study examined the impact of an intervention package consisting of contingent reinforcement and match-to-sample training on the independent progression of 3 children with ASD through Headsprout.sup.® Early Reading (HER), a behavior analytic online reading program. A multiple probe across participants design was used to examine the effects of the intervention package on participants' correct interactions per minute and total episodes completed. Transfer of training to oral reading of companion print books was also assessed. All participants demonstrated an increase in correct interactions per minute. Two participants learned to independently complete a HER episode each day and could orally read companion print books. The results suggest individualized behavior analytic programs can support the use of HER as a computer-based reading program for some children with ASD., Author(s): Joshua B. Plavnick[sup.1] , Julie L. Thompson[sup.1] , Carol Sue Englert[sup.1] , Troy Mariage[sup.1] , Katie Johnson[sup.1] Author Affiliations: (1) Department of Counseling, Educational Psychology, and Special Education, Michigan [...]

Published
2016
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10. sj-docx-2-pbi-10.1177_10983007221133525 – Supplemental material for Social-Emotional and Behavioral Support for First- and Second-Grade Black Learners at Risk for Emotional and Behavioral Problems

Author

Campbell, Aaron Rachelle, Sallese, Mary Rose, Thompson, Julie L., Burke, Mack D., and Allen, Meghan L.

Subjects
FOS: Psychology, 170199 Psychology not elsewhere classified, FOS: Educational sciences, 130312 Special Education and Disability, Education
Abstract

Supplemental material, sj-docx-2-pbi-10.1177_10983007221133525 for Social-Emotional and Behavioral Support for First- and Second-Grade Black Learners at Risk for Emotional and Behavioral Problems by Aaron Rachelle Campbell, Mary Rose Sallese, Julie L. Thompson, Mack D. Burke and Meghan L. Allen in Journal of Positive Behavior Interventions

Published
2022
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11. sj-docx-5-pbi-10.1177_10983007221133525 – Supplemental material for Social-Emotional and Behavioral Support for First- and Second-Grade Black Learners at Risk for Emotional and Behavioral Problems

Author

Campbell, Aaron Rachelle, Sallese, Mary Rose, Thompson, Julie L., Burke, Mack D., and Allen, Meghan L.

Subjects
FOS: Psychology, 170199 Psychology not elsewhere classified, FOS: Educational sciences, 130312 Special Education and Disability, Education
Abstract

Supplemental material, sj-docx-5-pbi-10.1177_10983007221133525 for Social-Emotional and Behavioral Support for First- and Second-Grade Black Learners at Risk for Emotional and Behavioral Problems by Aaron Rachelle Campbell, Mary Rose Sallese, Julie L. Thompson, Mack D. Burke and Meghan L. Allen in Journal of Positive Behavior Interventions

Published
2022
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12. sj-docx-1-pbi-10.1177_10983007221133525 – Supplemental material for Social-Emotional and Behavioral Support for First- and Second-Grade Black Learners at Risk for Emotional and Behavioral Problems

Author

Campbell, Aaron Rachelle, Sallese, Mary Rose, Thompson, Julie L., Burke, Mack D., and Allen, Meghan L.

Subjects
FOS: Psychology, 170199 Psychology not elsewhere classified, FOS: Educational sciences, 130312 Special Education and Disability, Education
Abstract

Supplemental material, sj-docx-1-pbi-10.1177_10983007221133525 for Social-Emotional and Behavioral Support for First- and Second-Grade Black Learners at Risk for Emotional and Behavioral Problems by Aaron Rachelle Campbell, Mary Rose Sallese, Julie L. Thompson, Mack D. Burke and Meghan L. Allen in Journal of Positive Behavior Interventions

Published
2022
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13. sj-docx-3-pbi-10.1177_10983007221133525 – Supplemental material for Social-Emotional and Behavioral Support for First- and Second-Grade Black Learners at Risk for Emotional and Behavioral Problems

Author

Campbell, Aaron Rachelle, Sallese, Mary Rose, Thompson, Julie L., Burke, Mack D., and Allen, Meghan L.

Subjects
FOS: Psychology, 170199 Psychology not elsewhere classified, FOS: Educational sciences, 130312 Special Education and Disability, Education
Abstract

Supplemental material, sj-docx-3-pbi-10.1177_10983007221133525 for Social-Emotional and Behavioral Support for First- and Second-Grade Black Learners at Risk for Emotional and Behavioral Problems by Aaron Rachelle Campbell, Mary Rose Sallese, Julie L. Thompson, Mack D. Burke and Meghan L. Allen in Journal of Positive Behavior Interventions

Published
2022
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14. sj-docx-6-pbi-10.1177_10983007221133525 – Supplemental material for Social-Emotional and Behavioral Support for First- and Second-Grade Black Learners at Risk for Emotional and Behavioral Problems

Author

Campbell, Aaron Rachelle, Sallese, Mary Rose, Thompson, Julie L., Burke, Mack D., and Allen, Meghan L.

Subjects
FOS: Psychology, 170199 Psychology not elsewhere classified, FOS: Educational sciences, 130312 Special Education and Disability, Education
Abstract

Supplemental material, sj-docx-6-pbi-10.1177_10983007221133525 for Social-Emotional and Behavioral Support for First- and Second-Grade Black Learners at Risk for Emotional and Behavioral Problems by Aaron Rachelle Campbell, Mary Rose Sallese, Julie L. Thompson, Mack D. Burke and Meghan L. Allen in Journal of Positive Behavior Interventions

Published
2022
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15. sj-docx-4-pbi-10.1177_10983007221133525 – Supplemental material for Social-Emotional and Behavioral Support for First- and Second-Grade Black Learners at Risk for Emotional and Behavioral Problems

Author

Campbell, Aaron Rachelle, Sallese, Mary Rose, Thompson, Julie L., Burke, Mack D., and Allen, Meghan L.

Subjects
FOS: Psychology, 170199 Psychology not elsewhere classified, FOS: Educational sciences, 130312 Special Education and Disability, Education
Abstract

Supplemental material, sj-docx-4-pbi-10.1177_10983007221133525 for Social-Emotional and Behavioral Support for First- and Second-Grade Black Learners at Risk for Emotional and Behavioral Problems by Aaron Rachelle Campbell, Mary Rose Sallese, Julie L. Thompson, Mack D. Burke and Meghan L. Allen in Journal of Positive Behavior Interventions

Published
2022
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16. Effect of Self-Monitoring on Personal Hygiene Among Individuals With Developmental Disabilities Attending Postsecondary Education.

Author

Gushanas, Christina M. and Thompson, Julie L.

Abstract

Research indicates that employers rate personal hygiene as the number one barrier to employment among individuals with developmental disabilities. However, there is limited literature on improving personal hygiene in preparation for employment among individuals with developmental disabilities. Using a multiple-baseline across-participants design, this study examined the effect of self-monitoring on personal hygiene among five individuals with developmental disabilities, ages 19 to 22 years, attending a postsecondary education program. A functional relation was demonstrated between self-monitoring and reduced distracting body odor. Limitations, suggestions for future research, and practical applications are provided. [ABSTRACT FROM AUTHOR]

Published
2019
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18. Alcohol Withdrawal Syndrome: Improving Recognition and Treatment in the Emergency Department.

Author

Glann, Judith K., Carman, Margaret, Thompson, Julie, Olson, David, Nuttall, Cynthia, Fleming, Holly, and Reese, Cheryl

Subjects
*ALCOHOL withdrawal syndrome treatment, *ALCOHOL withdrawal syndrome, *HEALTH facility employees, *STATISTICAL correlation, *FEAR, *FISHER exact test, *LENGTH of stay in hospitals, *HOSPITAL emergency services, *MEDICAL care, *EVALUATION of medical care, *PATIENTS, *QUALITY assurance, *SCALE analysis (Psychology), *T-test (Statistics), *PRE-tests & post-tests, *INTER-observer reliability, *MEDICAL records, *DATA analysis software, *ELECTRONIC health records, *DESCRIPTIVE statistics, *TERTIARY care, *KRUSKAL-Wallis Test, *DIAGNOSIS, *EDUCATION
Abstract

Alcoholism continues to be a persistent health problem in the United States, accounting for up to 62% of emergency department (ED) visits. This quality improvement (QI) project examined whether identifying the benefit for early use of Alcohol Use Disorders Identification Test (AUDIT C) and Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIW-ar) in the ED would avoid escalation of care and offset poor outcomes of alcohol withdrawal syndrome (AWS). A preimplementation chart review ( N= 99) showed an average of 12%-15% of patients requiring escalation of care at the project site. The QI project utilized a single-group, pre-/posttest design. The setting was a Southwest Veterans Affair tertiary care referral center. Thirty-five ED staff members were surveyed for baseline knowledge and attended education sessions, led by an advanced practice nurse, on the use of AUDIT-C and CIWA-ar. Posteducation, patients admitted to the hospital were screened with AUDIT-C and treated with CIWA-ar. Postimplementation, charts were reviewed for admitted patients ( N= 42) on the use of AUDIT-C, CIWA-ar, length of stay (LOS), and area patient treated. Although the test scores after didactic education were statistically significant ( p- 0.050), there was no significant difference in the use of AUDIT-C or CIWA-ar in the ED, nor a significant decrease in LOS for those patients with CIWA-ar ordered. However, the potential for clinical benefit could not be disavowed. Barriers to implementation included survey fatigue, inability to embed AUDIT-C in the electronicmedical record, inconsistency in completing AUDIT-C, interrater reliability, and patient fear of stigmatization. Advanced practice nurses provide an integral role to augment early identification and treatment of AWS in the ED. [ABSTRACT FROM AUTHOR]

Published
2019
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19. Nonspecialty Nurse Education: Evaluation of the Oncology Intensives Initiative, an oncology curriculum to improve patient care.

Author

Bagley, Kimberly A., Dunn, Sarah E., Chuang, Eliseu Y., Dorr, Victoria J., Thompson, Julie A., and Smith, Sophia K.

Subjects
*CANCER chemotherapy, *ONCOLOGY nursing, *CONFIDENCE, *STATISTICAL correlation, *CURRICULUM, *HOSPITALS, *NURSES, *NURSES' attitudes, *NURSING, *CONTINUING education of nurses, *NURSING specialties, *QUESTIONNAIRES, *SELF-efficacy, *STATISTICS, *T-test (Statistics), *TUMORS, *TEAMS in the workplace, *DATA analysis, *TEACHING methods, *PRE-tests & post-tests, *DESCRIPTIVE statistics
Abstract

BACKGROUND: A community hospital combined its medical and surgical patients with cancer on one unit, which resulted in nurses not trained in oncology caring for this patient population. OBJECTIVES: The Oncology Intensives Initiative (ONCii) involved the (a) design and implementation of a daylong didactic boot camp class and a four-hour simulation session and (b) the examination of nurses' worries, attitudes, self-efficacy, and perception of interdisciplinary teamwork. METHODS: A two-group, pre-/post-test design was implemented. Group 1 consisted of nurses who attended the didactic boot camp classes alone, whereas group 2 was comprised of nurses who attended the didactic boot camp classes and the simulation sessions. FINDINGS: Results of data analysis showed a decrease in worries and an increase in positive attitudes toward chemotherapy administration in both groups, as well as an increase in self-efficacy among members of group 2. [ABSTRACT FROM AUTHOR]

Published
2018
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20. On-demand pre-exposure prophylaxis with tenofovir disoproxil fumarate plus emtricitabine among men who have sex with men with less frequent sexual intercourse: a post-hoc analysis of the ANRS IPERGAY trial

Author

Laurence Meyer, Julie Chas, Jean-Guy Baril, Véronique Doré, Michel Morin, Jean-Pierre Aboulker, Marine Saouzanet, Isabelle Durant-Zaleski, Marie Suzan-Monti, Emmanuelle Netzer, Françoise Euphrasie, Nathalie Bajos, Séverine Gibowski, Soizic Le Mestre, Gilles Peytavin, Jean-François Delfraissy, Constance Delaugerre, David Thompson, Brigitte Guillon, Gilles Pialoux, Alpha Diallo, Nicolas Etien, Christian Chidiac, Michel Besnier, Isabelle Charreau, Benoit Trottier, Baptiste Demoulin, Julie Timsit, Bruno Spire, Joanne Otis, Laurent Cotte, Julien Fonsart, W. Rozenbaum, Mark A. Wainberg, Gabriel Girard, Eric Cua, Guillemette Antoni, Daniela Rojas Castro, Catherine Capitant, Luis Sagaon-Teyssier, Antoine Cheret, Marie-Christine Simon, Cécile Tremblay, Nicolas Leturque, Johan Binesse, Diane Carette, Valérie Foubert, Anaïs Mennecier, Grégoire Cattin, Jean-Michel Molina, Yacine Saïdi, Nicolas Lorente, Elias Choucair, François Raffi, Cecile Rabian, Armelle Pasquet, Marie Préau, Thomas Huleux, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Essais Thérapeutiques et Maladies Infectieuses, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CR CHUM), Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal (UdeM)-Université de Montréal (UdeM), Génomes, biologie cellulaire et thérapeutiques (GenCellDi (UMR_S_944)), Collège de France (CdF (institution))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP), Hôpital Archet 2 [Nice] (CHU), Coalition PLUS [Pantin, France] (Community Research Laboratory Pantin), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille] (ORS PACA), Centre d’Investigation Clinique de Nantes (CIC Nantes), Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre hospitalier universitaire de Nantes (CHU Nantes), CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Gustave Dron [Tourcoing], Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL), ANRS (France Recherche Nord and Sud Sida-HIV Hépatites), the Canadian HIV Trials Network, Fonds Pierre Bergé (Sidaction), Gilead Sciences, and the Bill & Melinda Gates Foundation., ANRS IPERGAY study group: Jean-Pierre Aboulker, Nathalie Bajos, Jean-Guy Baril, Michel Besnier, Johan Binesse, Diane Carette, Grégoire Cattin, Antoine Chéret, Christian Chidiac, Elias Choucair, Jean-François Delfraissy, Baptiste Demoulin, Alpha Diallo, Isabelle Durant-Zaleski, Véronique Doré, Nicolas Etien, Françoise Euphrasie, Julien Fonsart, Valérie Foubert, Séverine Gibowski, Gabriel Girard, Brigitte Guillon, Soizic Le Mestre, France Lert, Nicolas Leturque, Nicolas Lorente, Anaïs Mennecier, Michel Morin, Emmanuelle Netzer, Joanne Otis, Armelle Pasquet, Gilles Peytavin, Gilles Pialoux, Marie Préau, Cécile Rabian, Willy Rozenbaum, Luis Sagaon-Teyssier, Yacine Saïdi, Marine Saouzanet, Marie-Christine Simon, Marie Suzan-Monti, David Thompson, Julie Timsit, Benoît Trottier, Mark Wainberg, Dupuis, Christine, Génomes, biologie cellulaire et thérapeutiques (GenCellDi (U944 / UMR7212)), Collège de France (CdF (institution))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)

Subjects
0301 basic medicine, Male, MESH: Sexual Behavior, Epidemiology, [SDV]Life Sciences [q-bio], HIV Infections, Men who have sex with men, MESH: HIV-1, Pre-exposure prophylaxis, Sexual and Gender Minorities, 0302 clinical medicine, MESH: Tenofovir, Medicine, MESH: Double-Blind Method, 030212 general & internal medicine, MESH: Incidence, MESH: Anti-HIV Agents, education.field_of_study, Incidence (epidemiology), Incidence, MESH: HIV Infections, 3. Good health, [SDV] Life Sciences [q-bio], MESH: Sexual and Gender Minorities, Infectious Diseases, Pill, France, medicine.drug, Adult, medicine.medical_specialty, Canada, Anti-HIV Agents, Sexual Behavior, Immunology, Population, Placebo, Emtricitabine, Medication Adherence, MESH: Homosexuality, Male, 03 medical and health sciences, Double-Blind Method, MESH: Canada, Virology, Internal medicine, Humans, Homosexuality, Male, education, Tenofovir, MESH: Humans, business.industry, MESH: Adult, MESH: Medication Adherence, 030112 virology, MESH: Male, MESH: France, Sexual intercourse, HIV-1, Pre-Exposure Prophylaxis, business, MESH: Pre-Exposure Prophylaxis
Abstract

Summary Background ANRS IPERGAY found that on-demand pre-exposure prophylaxis (PrEP) with oral tenofovir disoproxil fumarate plus emtricitabine was associated with an 86% relative reduction of HIV-1 incidence compared with placebo among men who have sex with men at high risk of HIV. We aimed to investigate whether on-demand PrEP was similarly effective among individuals with lower exposure to HIV risk. Methods Participants in the ANRS IPERGAY trial were randomly assigned to receive PrEP (fixed-dose combination of 300 mg tenofovir disoproxil fumarate and 200 mg emtricitabine per pill) or placebo. The primary endpoint was the diagnosis of HIV-1 infection. Pill uptake was assessed by counting returned pills at each follow-up and by estimating tenofovir concentration from frozen plasma samples. Participants were interviewed at each visit to assess the pattern of PrEP use. All participants enrolled in the modified intention-to-treat population of the double-blind phase of the ANRS IPERGAY trial were eligible for this post-hoc analysis. We calculated the total follow-up time for periods of less frequent sexual intercourse with high PrEP adherence (15 pills or fewer per month taken systematically or often during sexual intercourse). To estimate the time of HIV acquisition, fourth-generation HIV-1/2 ELISA assays, plasma HIV-1 RNA assays, and western blot analyses were done with use of frozen samples, and the stage of HIV infection was defined according to Fiebig staging. HIV incidence was compared between the two treatment groups among individuals who had less frequent sexual intercourse with high PrEP adherence. The ANRS IPERGAY trial is registered with ClinicalTrials.gov , NCT01473472 . Findings 400 participants who were randomly assigned to receive PrEP (n=199) or placebo (n=201) between Feb 22, 2012, and Oct 17, 2014, were included in this analysis. 270 participants had at least one period of less frequent sexual intercourse with high PrEP adherence during the study, representing 134 person-years of follow-up and 31% of the total study follow-up. During these periods, participants in both groups reported a median of 5·0 (IQR 2·0–10·0) episodes of sexual intercourse per month and used a median of 9·5 (6·0–13·0) pills per month. Six HIV-1 infections were diagnosed in the placebo group (HIV incidence of 9·2 per 100 person-years; 95% CI 3·4–20·1) and none were diagnosed in the tenofovir disoproxil fumarate plus emtricitabine arm (HIV incidence of 0 per 100 person-years; 0–5·4; p=0·013), with a relative reduction of HIV incidence of 100% (95% CI 39–100). Interpretation A choice between daily or on-demand PrEP regimens could be offered to men who have sex with men who have less frequent sexual intercourse. Funding ANRS (France Recherche Nord and Sud Sida-HIV Hepatites), the Canadian HIV Trials Network, Fonds Pierre Berge (Sidaction), Gilead Sciences, and the Bill & Melinda Gates Foundation.

Published
2019

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