SEATTLE — Women and young patients are less likely to persistently use pre-exposure prophylaxis, or PrEP, for HIV prevention compared with men and older users, according to study data presented at CROI.
“In the Unites States, less than 10% of persons who would benefit from PrEP initiate it. For those who have started, some stop using it while at risk and become susceptible to HIV infection,” CDC researcher Ya-Lin A. Huang, PhD, MS, said during a news conference. “PrEP can reduce HIV incidence and help end the HIV epidemic; however, it requires persistent use during periods of risk to be effective.”
Huang clarified that persistence and adherence vary in definition. Adherence, she said, is the degree to which a person takes a drug or prescription as advised by their provider, whereas persistence is the length of use from initiation to discontinuation without disruption of longer than 30 days.
In their study, which used data from the IBM MarketScan Research Databases, Huang and colleagues focused on persistence and the contributing characteristics of it in a cohort of patients aged 18 to 64 years who initiated PrEP in the years 2012 to 2016. They deemed participants nonpersistent if they did not refill their prescription within 30 days after exhausting PrEP medications from a previous fill.
Of the 7,250 commercially insured PrEP users included in the study, 74.8% persisted for 6 months and 55.7% for 12 months, with female, young and rural residents being less likely to be persistent, according to adjusted estimates, Huang and colleagues reported. The median persistence was 14.5 months (95% CI, 13.9-15) but was significantly shorter for female PrEP users (6.9 months; 95% CI, 4.7-11.6) and for users aged 18 to 24 years (8.6 months; 95% CI, 7.4-9.3).
Huang said PrEP persistence is poorly understood and “would benefit from additional research to assess reasons for discontinuation and how these reasons associate with patient characteristics.”
A better understanding of PrEP persistence will help inform the design of programs and interventions to help overcome these challenges,” Huang said. “All in all, our study provides insight on PrEP use patterns and various groups. Our study findings underscore the need for interventions, specifically for priority populations, to support PrEP persistence.”– by Caitlyn Stulpin
Huang YA, et al. Abstract 84LB. Presented at: Conference on Retroviruses and Opportunistic Infections; March 4-7, 2019; Seattle.
Disclosure: Huang reports no relevant financial disclosures.