Do we Still Need Eligibility Criteria to Recommend PrEP? Impact of National Prescribing Requirements on Retention in Care and Sexually Transmitted Infections Acquisition.

PrEP Prescribing criteria Retention in care Sexually transmitted infections

Journal

AIDS and behavior
ISSN: 1573-3254
Titre abrégé: AIDS Behav
Pays: United States
ID NLM: 9712133

Informations de publication

Date de publication:
25 Mar 2024
Historique:
accepted: 12 03 2024
medline: 25 3 2024
pubmed: 25 3 2024
entrez: 25 3 2024
Statut: aheadofprint

Résumé

Italian guidelines recommend HIV pre-exposure prophylaxis (PrEP) only upon satisfying strict eligibility criteria. The objective of this study is to evaluate if PrEP candidates attending a community-based service comply with these criteria and whether these prescribing conditions affect retention in care and sexually transmitted infections (STIs) acquisition. A retrospective analysis was performed on PrEP candidates evaluated from January 2019 to June 2022. Data were collected from self-administered questionnaires and clinical files. The population was divided in subjects with 0/1 (0/1 C) and ≥ 2 (≥ 2 C) criteria. Descriptive statistics and non-parametric tests were employed to describe study population. Incidence of PrEP discontinuation and of STIs was estimated per 100 persons-year of follow up (PYFU), and incidence rate ratio (IRR) was calculated. Univariate and multivariable Cox regression analyses were used to evaluate the association strength between PrEP drop out and other variables. The analyses enrolled 659 individuals: 422 individuals were included in 0/1 C, 237 in ≥ 2 C group, respectively. Inconsistent condom use was the most reported prescribing criteria (399 individuals, 60.6%), followed by a previous STI (186 individuals, 28.2%). 0/1 C exhibited lower STIs incidence. PrEP discontinuation was 29% in 0/1 C and 38% in ≥ 2 C (p = 0.031). Cox model revealed that inconsistent condom use was the only prescribing criteria associated to PrEP persistence. The majority of PrEP candidate did not comply with prescribing conditions. Eligibility criteria failed to identify individuals with better retention in care. Our results suggest that Italian guidelines should be updated removing barriers to prescription.

Identifiants

pubmed: 38526636
doi: 10.1007/s10461-024-04320-3
pii: 10.1007/s10461-024-04320-3
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Auteurs

Roberto Rossotti (R)

Department of Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, Milan, 20162, Italy. roberto.rossotti@ospedaleniguarda.it.
Milano Checkpoint ETS, Milan, Italy. roberto.rossotti@ospedaleniguarda.it.

Alessandro Tavelli (A)

Milano Checkpoint ETS, Milan, Italy.
ICONA Foundation, Milan, Italy.

Daniele Calzavara (D)

Milano Checkpoint ETS, Milan, Italy.

Anna De Bona (A)

Milano Checkpoint ETS, Milan, Italy.
Department of Infectious Diseases, ASST Santi Paolo e Carlo, Milan, Italy.

Camilla Muccini (C)

Milano Checkpoint ETS, Milan, Italy.
Unit of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy.

Davide Moschese (D)

Milano Checkpoint ETS, Milan, Italy.
Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy.

Enrico Caruso (E)

Milano Checkpoint ETS, Milan, Italy.

Alessandro Soria (A)

Milano Checkpoint ETS, Milan, Italy.
Department of Infectious Diseases, IRCCS San Gerardo dei Tintori, Monza, Italy.

Simona Bossolasco (S)

Milano Checkpoint ETS, Milan, Italy.
Unit of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy.

Giuseppe Lapadula (G)

Milano Checkpoint ETS, Milan, Italy.
Department of Infectious Diseases, IRCCS San Gerardo dei Tintori, Monza, Italy.

Massimo Cernuschi (M)

Milano Checkpoint ETS, Milan, Italy.
Unit of Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy.

Antonella d'Arminio Monforte (AD)

Milano Checkpoint ETS, Milan, Italy.
ICONA Foundation, Milan, Italy.
School of Medicine, University of Milano, Milan, Italy.

Classifications MeSH