HealthDay News — Younger individuals, African American and Latinx individuals, and those with substance use disorders are more likely to have gaps in the continuum of care for preexposure prophylaxis (PrEP) for HIV, according to a study published online Aug. 26 in JAMA Network Open.
J. Carlo Hojilla, R.N., Ph.D., from Kaiser Permanente Northern California in Oakland, and colleagues identified individuals who received PrEP care between July 2012 and March 2019. A total of 13,906 individuals linked to PrEP care were followed up until March 2019, HIV diagnosis, discontinuation of health plan membership, or death.
The researchers found that 52.2 percent of individuals discontinued PrEP at least once after PrEP initiation; 60.2 percent subsequently reinitiated PrEP. Older individuals were more likely to receive a PrEP prescription and initiate PrEP compared with those aged 18 to 25 years (e.g., age >45 years: hazard ratios, 1.21 and 1.09, respectively) and they were less likely to discontinue PrEP (hazard ratio, 0.46). African American and Latinx individuals were less likely to receive a PrEP prescription (hazard ratios, 0.74 and 0.88, respectively) and initiate PrEP than White patients (hazard ratios, 0.87 and 0.90, respectively), and they were more likely to discontinue PrEP (hazard ratios, 1.36 and 1.33, respectively). The likelihood of being prescribed PrEP and initiating PrEP was lower and the likelihood of discontinuing PrEP was higher for women, those with lower neighborhood-level socioeconomic status, and for those with a substance use disorder.
“Comprehensive strategies tailored toward high-priority populations are needed to mitigate attrition along the PrEP continuum of care,” the authors write.
Two authors disclosed financial ties to the pharmaceutical industry.