N of cRAI in the past three months being reported more frequently in the placebo arm (P = 0.01). Of the 1,383 participants who tested seronegative for HSV-2 at baseline, 36 (2.6 ) did not contribute person-time to incidence analyses because they were retrospectively found to be HIVinfected at baseline, tested seropositive for HSV-2 at the enrollment visit subsequent to screening, or were lost to f
Used acyclovir or valacyclovir during study follow-up.HSV-2 prevalenceOf the 2,499 participants, 1383 (55.3 ) tested negative for HSV-2 at baseline, 892 (35.7 ) tested positive, 223 (8.9 ) had indeterminate tests, and one test was not done. Of the 223 with indeterminate tests at baseline, 114 (51.1 ) tested positive for HSV-2 infection at some point during follow-up. Factors associated with testin
Nversion to determine whether there were differences in ulcer occurrence by randomization group in the absence of study drug. All analyses were conducted in SAS 9.3 or Stata 12.Results Study participantsCharacteristics of the 2,499 iPrEx participants have been described previously. [13] Briefly, all participants were born male and 313 (13.0 ) identified as transgender or as women. The mean age at
Ination findings. Given the inhibition of HSV-2 replication observed after administration of tenofovir, it is biologically plausible that FTC/ TDF reduced the frequency or severity of ulcers. Unlike acyclovir, tenofovir does not require the presence of the herpes virus for drug activation, suggesting that it may suppress ulcers before phosphorylation occurs. However, topical dosing may be required
No differences by randomization group in the proportion of participants with 1 STI examination during which a perianal ulcer (FTC/TDF 3.5 vs. placebo 4.7 , P = 0.37) or groin ulcer (FTC/TDF 2.5 vs. placebo 1.9 , P = 0.51) was identified; results were similar after excluding participants with a positive syphilis rapid plasma reagin test at the same visit. However, symptoms that prompted STI exam
D ,25 years (7.1 per 100 person-years) and the lowest rate among participants aged 40 years (1.6 per 100 person-years; P trend = 0.001). Country of residence was also associated with HSV-2 incidence, with theDaily Oral FTC/TDF PrEP and HSV-2 among MSMthere were 72 ulcer AEs classified as Grade 2 or above, with 43 participants (4.3 ) having 1 ulcer AE. Among the 72 ulcer AEs, 23 (31.9 ) were conf
D ,25 years (7.1 per 100 person-years) and the lowest rate among participants aged 40 years (1.6 per 100 person-years; P trend = 0.001). Country of residence was also associated with HSV-2 incidence, with theDaily Oral FTC/TDF PrEP and HSV-2 among MSMthere were 72 ulcer AEs classified as Grade 2 or above, with 43 participants (4.3 ) having 1 ulcer AE. Among the 72 ulcer AEs, 23 (31.9 ) were conf
Tive to HIV. [12] Drug concentration is also affected by adherence; while iPrExhighest rate among participants living in Ecuador (9.7 per 100 person-years) and the lowest rate among participants living in Thailand (1.7 per 100 person-years). The only behavioral factor associated with time to HSV-2 incidence was ncRAI in the past three months (HR 2.0, 95 CI: 1.4-3.0; P,0.001). In multivariable ana