HIV pre-exposure prophylaxis persistence and adherence among men who have sex with men in 4 U.S. cities

Details

• Alternative Title:
  J Acquir Immune Defic Syndr
• Personal Author:
  Chapin-Bardales, Johanna ; Haaland, Richard ; Martin, Amy ; Holder, Angela ; Butts, Virginia A. ; Sionean, Catlainn ; Sey, Ekow Kwa ; Brady, Kathleen A. ; Raymond, Henry F. ; Opoku, Jenevieve ; Kuo, Irene ; Paz-Bailey, Gabriela ; Wejnert, Cyprian
• Corporate Authors:
  for the NHBS Study Group
• Description:
  Background:
  
  HIV pre-exposure prophylaxis (PrEP) persistence and adherence are critical to ending the HIV epidemic in the United States.
  
  Setting:
  
  In 2017 National HIV Behavioral Surveillance, HIV-negative men who have sex with men (MSM) in 4 U.S. cities completed a survey, HIV testing, and dried blood spots (DBS) at recruitment.
  
  Methods:
  
  We assessed three PrEP outcomes: persistence (self-reported PrEP use at any time in the past 12 months and had tenofovir, emtricitabine, or tenofovir diphosphate (TFV-DP) detected in DBS), adherence at ≥4 doses/week (self-reported past-month PrEP use and TFV-DP concentration ≥700 fmol/punch), and adherence at 7 doses/week (self-reported past-month PrEP use and TFV-DP concentration ≥1250 fmol/punch). Associations with key characteristics were examined using log-linked Poisson regression models with generalized estimating equations.
  
  Results:
  
  Among 391 MSM who took PrEP in the past year, persistence was 80% and was lower among MSM who were younger, had lower education, and had fewer sex partners. Of 302 MSM who took PrEP in the past month, adherence at ≥4 doses/week was 80% and adherence at 7 doses/week was 66%. Adherence was lower among MSM who were younger, were Black, and had fewer sex partners.
  
  Conclusions:
  
  Although persistence and adherence among MSM were high, 1 in 5 past-year PrEP users were not persistent and 1 in 5 past-month PrEP users were not adherent at levels that would effectively protect them from acquiring HIV (i.e., ≥4 doses/week). Efforts to support PrEP persistence and adherence should include MSM who are young, are Black, and have less education.
  
  
• Subjects:
  Anti-HIV Agents Cities HIV Infections Homosexuality, Male Humans Male Medication Adherence Pre-Exposure Prophylaxis Sexual And Gender Minorities United States
• Keywords:
  HIV HIV Pre-exposure Prophylaxis Men Who Have Sex With Men PrEP PrEP Adherence PrEP Persistence
• Source:
  J Acquir Immune Defic Syndr. 93(1):34-41
• Pubmed ID:
  36626893
• Pubmed Central ID:
  PMC11345832
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  93
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:a5cfc2180f0017138353adc7f1777fae9883be75a8dd4392e09af4182d1481cacfc82adda7b63cbc1ac221957247ee438b66dc03feb8cc2ab58857a5f1e55820
• Download URL:
  https://stacks.cdc.gov/view/cdc/160649/cdc_160649_DS1.pdf
• File Type:
  [PDF - 548.30 KB ]