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PrEP in the Real World: Predictors of 6-Month Retention in a Diverse Urban Cohort

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Abstract

The effectiveness of HIV pre-exposure prophylaxis (PrEP) depends on adherence, which requires retention in PrEP care. We sought to examine factors associated with six-month retention in PrEP care among individuals prescribed PrEP between 2011 and 2015 in a large, academic health system in the Bronx, New York. We used multivariable logistic regression to identify factors independently associated with six-month retention. Among 107 patients, retention at 6 months was 42%. In the multivariable analysis, heterosexual individuals were less likely to be retained in PrEP care at 6 months, but individuals who received prescriptions from attending physicians were more likely to be retained in care. Larger prospective studies are needed to better evaluate the individual and health system factors associated with long-term engagement in PrEP care.

Resumen

La efectividad de la Profilaxis de Pre-Exposición para el VIH (PrEP) depende de la adherencia, la cual requiere retención en el cuidado de PrEP. Buscamos examinar los factores asociados con la retención durante seis meses en el cuidado de PrEP, entre las personas a las cuales se les recetó PrEP entre los años 2011 y 2015 en un amplio sistema académico de salud en el Bronx, Nueva York. Utilizamos análisis de regresión logística multivariada para identificar los factores independientemente asociados con seis meses de retención. Entre 107 pacientes, la retención a los seis meses fue del 42%. En el análisis multivariado, las personas que se identificaron como heterosexuales fueron menos propensas a estar recibiendo el cuidado de PrEP a los seis meses, pero las que recibieron su receta de parte de los médicos asistentes tuvieron más probabilidad de retención en el cuidado de PrEP. Se necesitan estudios prospectivos más amplios para evaluar mejor los factores individuales y del sistema de salud asociados con la participación a largo plazo en el cuidado de PrEP.

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Funding

This work was supported in part by the Einstein-Rockefeller-CUNY Center for AIDS Research funded by the National Institutes of Health (P30-AI-051519). Viraj Patel is supported by K23-MH102118, Uriel Felsen is supported by K23-MH106386, and Oni Blackstock is supported by K23-MH102129.

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Correspondence to Cedric H. Bien-Gund.

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The authors declare that they have no conflicts of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments. For this type of study formal consent is not required.

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Lankowski, A.J., Bien-Gund, C.H., Patel, V.V. et al. PrEP in the Real World: Predictors of 6-Month Retention in a Diverse Urban Cohort. AIDS Behav 23, 1797–1802 (2019). https://doi.org/10.1007/s10461-018-2296-x

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  • DOI: https://doi.org/10.1007/s10461-018-2296-x

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