Time to Make the Jump: Translating HIV Pre-exposure Prophylaxis Research Into Real-World Public Health Impact

Patel, Rupa; Chan, Philip A.; Mena, Leandro; Crowley, Jeffrey S.; McCoy, Katryna; Nunn, Amy

doi:10.1097/qai.0000000000001386

Cited by 3 publications

(1 citation statement)

References 12 publications

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“…Moreover, copayment assistance programs may cover the costs of medication in the United States, but do not always cover other costs associated with PrEP such as lab and clinical service costs. (39, 40) In one of our studies, a participant tested positive for HIV after entering a high-risk period of sexual activity, but delaying PrEP re-initiation because his patience assistance program eligibility had ended. (41) Programs that support individuals in overcoming financial barriers to PrEP will be essential to support not only initiation, but also persistence on PrEP.…”

Section: Persistence On Prepmentioning

confidence: 98%

Getting pre-exposure prophylaxis (PrEP) to the people: opportunities, challenges and emerging models of PrEP implementation

Sullivan

Siegler

2018

Sex. Health

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Background/Purpose: Pre-exposure prophylaxis with TDF/FTC is now accepted as an efficacious approach to preventing HIV acquisition among people at high risk for HIV infection, but in most places, PrEP uptake to date has not been sufficient to make large impacts on HIV incidence. Approach: Here we consider several key elements of the effort to expand PrEP uptake for at-risk populations who would benefit most: Increasing access to PrEP, integrating PrEP programs with other services, promoting PrEP persistence, and developing systems for monitoring PrEP use. Outcomes/Impact: Access to PrEP includes regulatory issues and geographic proximity to PrEP providers. Integrating PrEP programs with other comprehensive sexual health services, through clinic-based programs or through technology-based approaches, offers opportunities to identify PrEP candidates and improve linkages to PrEP care. Once at-risk people are prescribed PrEP, lowering barriers to persistence on PrEP is critical to realizing the most population benefits. To understand progress and identify under-served groups and communities, systems to monitor the uptake of PrEP are needed. Significance/Innovation: We argue that making the most of a new biomedical intervention tool requires ongoing research about implementation, scaleup through multiple channels, including community-based organizations, and high-quality monitoring of uptake. We must turn to questions of PrEP implementation and continue to seek innovative approaches to reduce barriers to PrEP uptake and persistence on PrEP.

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Section: Persistence On Prepmentioning

confidence: 98%

Getting pre-exposure prophylaxis (PrEP) to the people: opportunities, challenges and emerging models of PrEP implementation

Sullivan

Siegler

2018

Sex. Health

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Long‐term retention in pre‐exposure prophylaxis care among men who have sex with men and transgender women in the United States

et al. 2019

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Introduction Retention in HIV pre‐exposure prophylaxis (PrEP) care in real‐world settings, outside of controlled trials or demonstration projects, remains poorly understood. Methods 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. Results 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. Conclusions 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.

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Open pilot trial of a brief motivational interviewing-based HIV pre-exposure prophylaxis intervention for men who have sex with men: preliminary effects, and evidence of feasibility and acceptability

et al. 2019

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Time to Make the Jump: Translating HIV Pre-exposure Prophylaxis Research Into Real-World Public Health Impact

Cited by 3 publications

References 12 publications

Getting pre-exposure prophylaxis (PrEP) to the people: opportunities, challenges and emerging models of PrEP implementation

Getting pre-exposure prophylaxis (PrEP) to the people: opportunities, challenges and emerging models of PrEP implementation

Long‐term retention in pre‐exposure prophylaxis care among men who have sex with men and transgender women in the United States

Open pilot trial of a brief motivational interviewing-based HIV pre-exposure prophylaxis intervention for men who have sex with men: preliminary effects, and evidence of feasibility and acceptability

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