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. 2023 Feb;27(2):473-483.
doi: 10.1007/s10461-022-03782-7. Epub 2022 Aug 5.

Risk Factors Associated with Loss to Follow-up Among Transgender Women Receiving HIV Pre-exposure Prophylaxis in Chiang Mai province, Thailand

Natthapat Thongsak  1 , Natthaporn Manojai  2 , Rathawit Apiputhipan  2 , Nicha Rongram  3 , Natnita Mattawanon  4 , Walaithip Bunyatisai  1   5 , Bandhita Plubin  1   5 , Nawapon Nakharutai  1   5 , Salinee Thumronglaohapun  1   5 , Pimwarat Srikummoon  1   5 , Kanokkan Wongsawat  1 , Patrinee Traisathit  1   5   6 , Nontiya Homkham  7
Affiliations

Risk Factors Associated with Loss to Follow-up Among Transgender Women Receiving HIV Pre-exposure Prophylaxis in Chiang Mai province, Thailand

Natthapat Thongsak et al. AIDS Behav. 2023 Feb.

Abstract

Although HIV pre-exposure prophylaxis (PrEP) is free in Thailand, many transgender women discontinue taking it after initiation. We determined the loss to follow-up (LTFU) rate of transgender women who initiated PrEP at the Mplus Foundation, Chiang Mai, Thailand, and identified associated risk factors using Cox proportional hazard models. Of 235 participants who initiated PrEP, 59 (55%) out of 108 remaining participants had reactive syphilis. The LTFU rate at 6 months was 38% (95% confidence interval [CI]: 29-48%). Multivariable analysis indicates that LTFU is independently associated with age ≥ 26 years old (adjusted hazard ratio [aHR] = 2.09; 95% CI: 1.06-4.14) and reactive syphilis (aHR = 1.98; 95% CI:1.01-3.88). Delayed appointment scheduling by the PrEP providers and the syphilis clinic was associated with transgender women having reactive syphilis, and the lockdown policy during the COVID-19 pandemic might have influenced them to discontinue PrEP and their subsequent LTFU.

Keywords: Loss to follow-up; PrEP; Preventing HIV; Thailand; Transgender women.

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Conflict of interest statement

There are no conflicts of interest in the conduct and reporting of the research.

Figures

Fig. 1
Fig. 1
Cumulative loss to follow-up rate within 6 months after pre-exposure prophylaxis initiation. The lost to follow-up in both groups was increasing after 1 month from start pre-exposure prophylaxis
Fig. 2
Fig. 2
Cumulative loss to follow-up rate up to 6 months after PrEP initiation by (a) age group and (b) syphilis infection status. LTFU was significantly higher in the older transgender women group (solid line) than the younger group (long-dashed line). LTFU was significantly higher in the transgender women living with syphilis (solid line) than those with non-reactive syphilis (long-dashed line)
See this image and copyright information in PMC

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