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HIV Pre-exposure Prophylaxis Persistence and Adherence Among Men Who Have Sex With Men in Four US Cities. | LitMetric

AI Article Synopsis

  • - HIV pre-exposure prophylaxis (PrEP) is essential for reducing the HIV epidemic in the US, with a focus on persistence and adherence among HIV-negative men who have sex with men (MSM) in four cities.
  • - A 2017 study found that 80% of the 391 MSM who used PrEP in the past year were persistent, but younger individuals, those with lower education, and fewer sex partners showed lower rates of persistence and adherence.
  • - Although high adherence rates were observed, around 20% of MSM did not adhere to the recommended four doses per week, highlighting the need for targeted support for younger, Black MSM with lower education levels to improve these outcomes.

Article 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 US cities completed a survey, HIV testing, and dried blood spots at recruitment.

Methods: We assessed 3 PrEP outcomes: persistence (self-reported PrEP use at any time in the past 12 months and had tenofovir, emtricitabine, or tenofovir diphosphate detected in dried blood spots), adherence at ≥4 doses/week (self-reported past-month PrEP use and tenofovir diphosphate concentration ≥700 fmol/punch), and adherence at 7 doses/week (self-reported past-month PrEP use and tenofovir diphosphate 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 (ie, ≥4 doses/week). Efforts to support PrEP persistence and adherence should include MSM who are young, are Black, and have less education.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11345832PMC
http://dx.doi.org/10.1097/QAI.0000000000003160DOI Listing

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