Florian Voit

This session delved into HIV and STI prevention, examining barriers and facilitators to DoxyPEP adherence, the impact of DoxyPrEP on STI rates, sex workers' challenges with condom use and PrEP in Germany, PrEP perceptions among adolescent MSM and transgender women in Brazil, and findings from the PrEPVacc vaccine trial.

This session provided critical insights into HIV and STI prevention strategies. Benn Kwach from Kenya Medical Research Institute discussed barriers like side effects, stigma, and partner reactions, and facilitators such as STI risk awareness and discreet pill cases for DoxyPEP adherence among young women in Kenya. Seitaro Abe from the National Center for Global Health and Medicine, Japan, presented an important study demonstrating that DoxyPrEP significantly reduced STI rates among female sex workers without affecting vaginal bacterial flora, highlighting its potential as an effective intervention in populations at higher risk. Eléonore Willems from Deutsche Aidshilfe, Germany, highlighted the lack of awareness and pressures sex workers face regarding condomless sex and PrEP, emphasizing the need for better education and support. Suelen Seixas from Universidade do Estado da Bahia, Brazil, presented on PrEP perceptions among adolescent MSM and transgender women, noting the significant role of positive perceptions in PrEP initiation and the necessity for targeted educational interventions. Eugene Ruzagira from the MRC/UVRI & LSHTM Uganda discussed the final efficacy results of the PrEPVacc trial, concluding that the vaccines evaluated did not reduce HIV infection, and the wide confidence intervals and low placebo arm incidence preclude definitive conclusions.

The session emphasized the importance of understanding barriers and facilitators to prophylaxis adherence and necessity for culturally-tailored interventions. The significant impact of DoxyPrEP on reducing STI rates among female sex workers was a key highlight. It is one of two small studies presented at AIDS 2024 suggesting DoxyPrEP is promising for STI prevention, but more research is needed to address concerns about antibiotic resistance. The session emphasized the need for expanded education on PrEP, addressing stigma, and supporting sex workers in negotiating safer practices. The efficacy result from the PrEPVacc trial calls for further immunological analyses to understand the results.