Depression and Oral FTC/TDF Pre-exposure Prophylaxis (PrEP) Among Men and Transgender Women Who Have Sex With Men (MSM/TGW)
We conducted a longitudinal and cross-sectional analysis of depressive symptomology in iPrEx, a randomized, placebo-controlled trial of daily, oral FTC/TDF HIV pre-exposure prophylaxis (PrEP) in men and transgender women who have sex with men. Depression-related adverse events (AEs) were the most frequently reported severe or life-threatening AEs and were not associated with being randomized to the FTC/TDF arm (152 vs. 144 respectively OR 0.66 95 % CI 0.35–1.25). Center for Epidemiologic Studies Depression scale (CES-D) and a four questions suicidal ideation scale scores did not differ by arm. Participants reporting forced sex at anal sexual debut had higher CES-D scores (coeff: 3.23; 95 % CI 1.24–5.23) and were more likely to have suicidal ideation (OR 2.2; 95 % CI 1.09–4.26). CES-D scores were higher among people reporting non-condom receptive anal intercourse (ncRAI) (OR 1.46; 95 % CI 1.09–1.94). We recommend continuing PrEP during periods of depression in conjunction with provision of mental health services. Llevamos a cabo un análisis logitudinal y transversal de la sintomatologia depresiva en iPrEx, del estudio de placebo controlado, con seleccion de brazo al azar. Involucra tratamiento oral diario de FTC/TDF que esta usado como quimoprofilaxis de pre-exposicion (PrEP) contra VIH en hombres y mujeres transgénero que tienen relaciones sexuales con hombres (MSM/TGW). Eventos relacionados a depresion (AEs) fueron reportados como los sintomas mas adversos o de riesgo de vida. Estos no fueron asociados con la seleccion al azar del brazo FTC/TDF (152 contra 144 respectivamente; OR: 0.66; 95 % CI: 0.35-1.25). La escala de depresion (CES-D), que proviene del centro de Estudios Epidemiológicos de Depresion y un “filtro” con cuatro preguntas para detectar suicidios contemplados no difirieron entre los brazos. Personas que reportaron ser forzados tener sexo, siendo su primer encuentro con sexo anal, tenian CES-D resultados mas altos (Coeff: 3.23; 95 % CI: 1.24 a 5.23) y fueron mas probable contemplar suicidio (OR 2.2; 95 % CI: 1.09 a 4.26). CES-D resultados fueron mas altos en personas reportando recibir penetracion anal sin condon (ncRAI) (OR: 1.46; 95 % CI: 1.09 a 1.94). Recomendamos continuar PrEP durante periodos de depresion, mientras simultaneamente recibir servicios de salud mental.