Long-term retention in pre-exposure prophylaxis care among men who have sex with men and transgender women in the United States.
Adolescent
Adult
Black or African American
Anti-HIV Agents
/ administration & dosage
Female
HIV Infections
/ drug therapy
Homosexuality, Male
Humans
Male
Medication Adherence
Pre-Exposure Prophylaxis
/ statistics & numerical data
Self Report
Sexual and Gender Minorities
Time Factors
Transgender Persons
United States
Young Adult
HIV prevention
PrEP
adherence
clinical care
retention in care
Journal
Journal of the International AIDS Society
ISSN: 1758-2652
Titre abrégé: J Int AIDS Soc
Pays: Switzerland
ID NLM: 101478566
Informations de publication
Date de publication:
08 2019
08 2019
Historique:
received:
22
02
2019
accepted:
31
07
2019
entrez:
20
8
2019
pubmed:
20
8
2019
medline:
29
4
2020
Statut:
ppublish
Résumé
Retention in HIV pre-exposure prophylaxis (PrEP) care in real-world settings, outside of controlled trials or demonstration projects, remains poorly understood. We evaluated retention in PrEP care outcomes among men who have sex with men (MSM) and transgender women prescribed PrEP through March 2017 at three clinical sites in the United States (US): Jackson, Mississippi; Providence, Rhode Island; and St. Louis, Missouri. We determined retention rates by attendance of clinical visits every three months, per US Centers for Disease Control and Prevention (CDC) guidelines, as well as by the timing of patients' actual clinical visits. Multivariable analyses examined demographic and behavioural factors associated with retention. From 2013 to 2015, 282 MSM and transgender women were prescribed PrEP; 82% attended a follow-up visit. Based on CDC recommendations, 56% of patients were retained in PrEP care at the first follow-up visit, having attended a visit three months after initiation. However, 76% had a follow-up visit within eight months. Thirty-percent were retained at 12 months by CDC criteria, but 62% were retained when using a 16-month endpoint. Self-reported adherence was strongly correlated with retention. In multivariable analyses, younger age was associated with decreased odds of retention at initial follow-up, and completing college was associated with increased odds of retention at 16 months. Eight participants were newly diagnosed with HIV; six were African American, and seven were under 30 years of age. Measuring retention in PrEP care using three-month follow-up intervals may underestimate true retention. Nevertheless, retention in PrEP care is suboptimal in real-world settings and should be the focus of future interventions.
Identifiants
pubmed: 31423756
doi: 10.1002/jia2.25385
pmc: PMC6698689
doi:
Substances chimiques
Anti-HIV Agents
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
e25385Subventions
Organisme : NIMH NIH HHS
ID : R25 MH083620
Pays : United States
Informations de copyright
© 2019 The Authors. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of the International AIDS Society.
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