Full Citation
Title: Understanding Typology of prep Persistence Trajectories among Male prep Users in the U.S
Citation Type: Miscellaneous
Publication Year: 2007
ISBN:
ISSN:
DOI: 10.1093/ofid/ofae584
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Abstract: Introduction: Understanding longitudinal patterns of PrEP use among men who have sex with men (MSM) could offer insights for developing efficient and timely interventions to promote PrEP persistence. Setting: We extracted two years of pharmacy fill records for 4,000 males who initiated PrEP in 2017 at a national chain pharmacy in the US. Methods: Group-based trajectory models were used to develop PrEP trajectory clusters, with periods of use defined based on optimal PrEP seroprotection probabilities (i.e., PrEP use frequency ≥ 4 doses/week). Multinomial logistic regressions were used to evaluate the associations between sociodemographic covariates and identified trajectory group membership. Results: We identified four distinct groups of PrEP persistence trajectories: 1) persistent use of PrEP throughout the period (persistent user), 2) brief use followed by sustained cessation of PrEP use (brief user), 3) PrEP use up to the mid-term followed by sustained cessation of PrEP use (mid-term user), and 4) PrEP use, followed by cessation and subsequent re-initiation (PrEP re-initiator). 2 Persistent users and brief users accounted for 40.1% and 22.9% of the population, respectively, while mid-term users and re-initiators accounted for 18.9% and 18.2%, respectively. Older age at PrEP initiation, commercial insurance as the primary payer of PrEP, and use of specialty pharmacy were found to be associated with persistent PrEP use over the other patterns of non-persistence. Conclusions: Subgroups of PrEP users could benefit from PrEP persistence interventions that target specific timings of likely PrEP cessation or considerations of re-initiation. Key Points: Analysis of nationwide PrEP fill data revealed four use trajectories. Heterogenous timings of PrEP cessations and re-initiation suggest tailored interventions for persistence. Association of persistence with specialty pharmacy use and insurance underscores the importance of financial and medication adherence support.
Url: https://academic.oup.com/ofid/advance-article/doi/10.1093/ofid/ofae584/7818443
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Authors: Chen, Yi-No; Zhou, Junlan; Kirkham, Heather S; Witt, Edward A; Jenness, Samuel M; Wall, Kristin M; Kamaleswaran, Rishi; Naimi, Ashley I; Siegler, Aaron J
Publisher: Open Forum Infectious Diseases
Data Collections: IPUMS NHGIS
Topics: Gender, Reproductive and Sexual Health
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