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Understanding Retention in Pre-Exposure Prophylaxis Care in the South: Insights from an Academic HIV Prevention Clinic

HIV pre-exposure prophylaxis (PrEP) is poorly utilized in the southern United States. We examined PrEP retention in care and sexually transmitted infections (STIs) through a retrospective review of the Duke University PrEP Clinic from January 1, 2015 to October 15, 2019. We evaluated short-term (3 m...

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Autores principales: Burns, Charles M., Borges, Monica, Frye, Justin, Keicher, Kathryn, Elliott, Scotty, Schwartz, Sheila, Shipp, Kenneth, Okeke, Nwora Lance, McKellar, Mehri S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Mary Ann Liebert, Inc., publishers 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9048170/
https://www.ncbi.nlm.nih.gov/pubmed/35172632
http://dx.doi.org/10.1089/aid.2021.0177
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author Burns, Charles M.
Borges, Monica
Frye, Justin
Keicher, Kathryn
Elliott, Scotty
Schwartz, Sheila
Shipp, Kenneth
Okeke, Nwora Lance
McKellar, Mehri S.
author_facet Burns, Charles M.
Borges, Monica
Frye, Justin
Keicher, Kathryn
Elliott, Scotty
Schwartz, Sheila
Shipp, Kenneth
Okeke, Nwora Lance
McKellar, Mehri S.
author_sort Burns, Charles M.
collection PubMed
description HIV pre-exposure prophylaxis (PrEP) is poorly utilized in the southern United States. We examined PrEP retention in care and sexually transmitted infections (STIs) through a retrospective review of the Duke University PrEP Clinic from January 1, 2015 to October 15, 2019. We evaluated short-term (3 months), long-term (additional 8–12 months), and longitudinal retention in care in our clinic. Adjusted odds ratios (aOR) were generated to explore demographics associated with retention. Kaplan–Meier curves were generated to view retention longitudinally. STIs were examined at baseline (1 year before initial PrEP visit) and while retained in care. Of a total of 255 patients; 88% were men, 37% were black, and 73% were men who have sex with men (MSM). Short- and long-term retention in care were met by 130/237 (55%) and 80/217 (37%) patients, respectively. MSM were more likely to be retained in the short term (aOR = 5.22, 95% confidence interval [CI] = 1.57–17.32). Self-referred patients were more likely to be retained in the long term (aOR = 2.18, 95% CI = 1.12–4.23). Uninsured patients were less likely to be retained in the long term (aOR = 0.32, 95% CI = 0.11–0.91). STI diagnoses include 42 infections at baseline and 69 infections during follow-up. STI diagnosed while in PrEP care was associated with longer retention in care over time. Patients discontinue PrEP care over time and STIs were frequently encountered. Additional studies are needed to determine the best way to retain patients in HIV preventative care.
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spelling pubmed-90481702022-04-28 Understanding Retention in Pre-Exposure Prophylaxis Care in the South: Insights from an Academic HIV Prevention Clinic Burns, Charles M. Borges, Monica Frye, Justin Keicher, Kathryn Elliott, Scotty Schwartz, Sheila Shipp, Kenneth Okeke, Nwora Lance McKellar, Mehri S. AIDS Res Hum Retroviruses Outcomes Research HIV pre-exposure prophylaxis (PrEP) is poorly utilized in the southern United States. We examined PrEP retention in care and sexually transmitted infections (STIs) through a retrospective review of the Duke University PrEP Clinic from January 1, 2015 to October 15, 2019. We evaluated short-term (3 months), long-term (additional 8–12 months), and longitudinal retention in care in our clinic. Adjusted odds ratios (aOR) were generated to explore demographics associated with retention. Kaplan–Meier curves were generated to view retention longitudinally. STIs were examined at baseline (1 year before initial PrEP visit) and while retained in care. Of a total of 255 patients; 88% were men, 37% were black, and 73% were men who have sex with men (MSM). Short- and long-term retention in care were met by 130/237 (55%) and 80/217 (37%) patients, respectively. MSM were more likely to be retained in the short term (aOR = 5.22, 95% confidence interval [CI] = 1.57–17.32). Self-referred patients were more likely to be retained in the long term (aOR = 2.18, 95% CI = 1.12–4.23). Uninsured patients were less likely to be retained in the long term (aOR = 0.32, 95% CI = 0.11–0.91). STI diagnoses include 42 infections at baseline and 69 infections during follow-up. STI diagnosed while in PrEP care was associated with longer retention in care over time. Patients discontinue PrEP care over time and STIs were frequently encountered. Additional studies are needed to determine the best way to retain patients in HIV preventative care. Mary Ann Liebert, Inc., publishers 2022-04-01 2022-04-06 /pmc/articles/PMC9048170/ /pubmed/35172632 http://dx.doi.org/10.1089/aid.2021.0177 Text en © Charles M. Burns et al. 2022; Published by Mary Ann Liebert, Inc. https://creativecommons.org/licenses/by/4.0/This Open Access article is distributed under the terms of the Creative Commons License [CC-BY] (http://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Outcomes Research
Burns, Charles M.
Borges, Monica
Frye, Justin
Keicher, Kathryn
Elliott, Scotty
Schwartz, Sheila
Shipp, Kenneth
Okeke, Nwora Lance
McKellar, Mehri S.
Understanding Retention in Pre-Exposure Prophylaxis Care in the South: Insights from an Academic HIV Prevention Clinic
title Understanding Retention in Pre-Exposure Prophylaxis Care in the South: Insights from an Academic HIV Prevention Clinic
title_full Understanding Retention in Pre-Exposure Prophylaxis Care in the South: Insights from an Academic HIV Prevention Clinic
title_fullStr Understanding Retention in Pre-Exposure Prophylaxis Care in the South: Insights from an Academic HIV Prevention Clinic
title_full_unstemmed Understanding Retention in Pre-Exposure Prophylaxis Care in the South: Insights from an Academic HIV Prevention Clinic
title_short Understanding Retention in Pre-Exposure Prophylaxis Care in the South: Insights from an Academic HIV Prevention Clinic
title_sort understanding retention in pre-exposure prophylaxis care in the south: insights from an academic hiv prevention clinic
topic Outcomes Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9048170/
https://www.ncbi.nlm.nih.gov/pubmed/35172632
http://dx.doi.org/10.1089/aid.2021.0177
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