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. 2022 Feb 1;89(2):166-171.
doi: 10.1097/QAI.0000000000002833.

Long-term HIV Pre-exposure Prophylaxis Trajectories Among Racial & Ethnic Minority Patients: Short, Declining, & Sustained Adherence

Maria Pyra  1   2 , Russell Brewer  2 , Laura Rusie  1 , Jeanelle Kline  1 , India Willis  1 , John Schneider  1   2
Affiliations

Long-term HIV Pre-exposure Prophylaxis Trajectories Among Racial & Ethnic Minority Patients: Short, Declining, & Sustained Adherence

Maria Pyra et al. J Acquir Immune Defic Syndr. .

Abstract

Background: HIV pre-exposure prophylaxis (PrEP) requires continued use at an effective dosage to reduce HIV incidence. Data suggest early PrEP drop-off among many populations. We sought to describe PrEP use over the first year among racial and ethnic minority patients in the US.

Setting: Racial and ethnic minority patients initiating PrEP at a federally qualified health center in Chicago, IL.

Methods: Using electronic health records, we determined the adherence (≥6 weekly doses) trajectories over the first year of PrEP use and compared baseline and time-varying patient characteristics.

Results: From 2159 patients, we identified 3 PrEP use trajectories. Sustained use was the most common (40%) trajectory, followed by short use (30%) and declining use (29%). In adjusted models, younger age, Black race, as well as gender, sexual orientation, insurance status at baseline, and neighborhood were associated with trajectory assignment; within some trajectories, insurance status during follow-up was associated with odds of monthly adherence (≥6 weekly doses).

Conclusion: Among racial and ethnic minorities, a plurality achieved sustained PrEP persistence. Access to clinics, insurance, and intersectional stigmas may be modifiable barriers to effective PrEP persistence; in addition, focus on younger users and beyond gay, cismale populations are needed.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Observed and Predicted Adherence by Assigned PrEP Use Trajectory (95% CI)
See this image and copyright information in PMC

References

    1. Baeten JM, Donnell D, Ndase P, et al. Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. New England Journal of Medicine. 2012;367(5):399–410. doi: 10.1056/NEJMoa1108524 - DOI - PMC - PubMed
    1. Grant RM, Lama JR, Anderson PL, et al. Preexposure Chemoprophylaxis for HIV Prevention in Men Who Have Sex with Men. New England Journal of Medicine. 2010;363(27):2587–2599. doi: 10.1056/NEJMoa1011205 - DOI - PMC - PubMed
    1. Haberer JE, Bangsberg DR, Baeten JM, et al. Defining success with HIV pre-exposure prophylaxis: a prevention-effective adherence paradigm. AIDS. 2015;29(11):1277–1285. doi: 10.1097/QAD.0000000000000647 - DOI - PMC - PubMed
    1. Pyra MN, Haberer JE, Hasen N, Reed J, Mugo NR, Baeten JM. Global implementation of PrEP for HIV prevention: setting expectations for impact. Journal of the International AIDS Society. 2019;22(8). doi: 10.1002/jia2.25370 - DOI - PMC - PubMed
    1. Pyra M, Rusie L, Castro M, et al. A taxonomy of pragmatic measures of HIV preexposure prophylaxis use. AIDS. 2020;34(13):1951–1957. doi: 10.1097/QAD.0000000000002618 - DOI - PMC - PubMed

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