PrEP initiation and follow-up
As described in the trial protocol [The expense of physical examinations (including required lab tests), PrEP prescriptions and PrEP medications was partially covered by the study. Participants paid for their PrEP medications 100% out-of-pocket up-front, and then submitted a copy of their receipt (digital or hard-copy) to the research team to get 50% of the cost reimbursed. After reimbursement, the total estimated cost to a participant who started PrEP was from 590 CNY [90 USD] for one-month generic PrEP supply or 30 pills ([200 mg emtricitabine, 300 mg tenofovir disoproxil (fumarate)] [90 USD/month]) to 2000 CNY (307 USD) for a two-month supply of Truvada ([200 mg emtricitabine, 300 mg tenofovir disoproxil (fumarate)] [153 USD/month]). Once starting PrEP, participants were required to complete two monthly clinic visits during their first two months of PrEP use to monitor their medication adherence, HIV/STI status, and overall physical health status. Participants who decided to start or continue PrEP after Week 8 would still be able to receive standard PrEP care at the study hospital, but the expense for lab tests and PrEP medications was no longer reimbursed. All participants were informed during their last virtual study visit that another PrEP demonstration project at the study-affiliated hospital would be open for enrollment in late 2021, where they could continue accessing PrEP.