Patterns of PrEP Retention Among HIV Pre-exposure Prophylaxis Users in Baltimore City, Maryland

HIV pre-exposure prophylaxis (PrEP) retention, defined as quarterly clinical evaluation, is critical to reducing HIV incidence. Our objectives were to determine: (1) visit- and individual-level PrEP retention patterns; (2) and individual-level characteristics associated with low-level PrEP retention...

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Podrobná bibliografia
Vydané v:	Journal of acquired immune deficiency syndromes (1999) Ročník 85; číslo 5; s. 593
Hlavní autori:	Wu, Linxuan, Schumacher, Christina, Chandran, Aruna, Fields, Errol, Price, Ashley, Greenbaum, Adena, Jennings, Jacky M
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	United States 15.12.2020
Predmet:	Adult Baltimore - epidemiology Continental Population Groups - statistics & numerical data Female HIV Infections - prevention & control Humans Male Medication Adherence - statistics & numerical data Pre-Exposure Prophylaxis - statistics & numerical data Risk Factors Sexual Behavior - statistics & numerical data Young Adult Baltimore
ISSN:	1944-7884, 1944-7884
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Popis
Shrnutí:	HIV pre-exposure prophylaxis (PrEP) retention, defined as quarterly clinical evaluation, is critical to reducing HIV incidence. Our objectives were to determine: (1) visit- and individual-level PrEP retention patterns; (2) and individual-level characteristics associated with low-level PrEP retention 12 months after initiation among PrEP users in Baltimore City, Maryland. Information was abstracted from medical records among individuals initiating PrEP between October 1, 2015 and February 28, 2018. Visit-level PrEP retention was defined as evidence of PrEP use, documented PrEP prescription, or current PrEP use at each quarterly follow-up visit. Low-level PrEP retention was defined as <3/4 quarters with documented PrEP use. Multilevel mixed effects Poisson regression was used to determine characteristics associated with low-level PrEP retention. Among 412 individuals initiating PrEP and followed for 12 months, the majority was: cis-gender male (83.7%, n = 345), non-Hispanic Black (56.3%, n = 232) and gay, bisexual, or other man who has sex with men (74.0%, n = 305). By quarterly visits, PrEP retention was: 3-month: 69.4% (n = 286); 6-month: 51.9% (n = 214); 9-month: 44.5% (n = 183); and 12-month: 41.1% (n = 169). Three-fifths (58.5%, n = 241) had low-level PrEP retention. Cis-gender females (vs. cis-gender males) (adjusted relative risk: 1.36, 95% confidence interval: 1.04 to 1.77) were more likely to have low-level PrEP retention. Our observed PrEP retention rates are lower than what may be needed to reduce HIV incidence. Future research should examine individual- and clinic-level barriers and facilitators to PrEP retention programs by key population to inform interventions for PrEP retention.
Bibliografia:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1944-7884 1944-7884
DOI:	10.1097/QAI.0000000000002506