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

Authors

Johanna Chapin-Bardales, Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
Richard Haaland, Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
Amy Martin, Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
Angela Holder, Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
Virginia A. Butts, Libra Management Group, Decatur, GA.
Catlainn Sionean, Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
Ekow Kwa Sey, Los Angeles County Department of Public Health, Los Angeles, CA.
Kathleen A. Brady, Philadelphia Department of Public Health, Philadelphia, PA.
Henry F. Raymond, Rutgers University, Newark, NJ.
Jenevieve Opoku, District of Columbia Department of Health, Washington, DC.
Irene Kuo, George Washington University, Washington, DC.
Gabriela Paz-Bailey, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, PR.
Cyprian Wejnert, Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA.

Document Type

Journal Article

Publication Date

1-9-2023

Journal

Journal of acquired immune deficiency syndromes (1999)

DOI

10.1097/QAI.0000000000003160

Abstract

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.

APA Citation

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; and Wejnert, Cyprian, "HIV pre-exposure prophylaxis persistence and adherence among men who have sex with men in 4 U.S. cities" (2023). GW Authored Works. Paper 2290.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/2290

Department

Epidemiology