Pre-exposure Prophylaxis Discontinuation During the COVID-19 Pandemic Among Men Who Have Sex With Men in a Multisite Clinical Cohort in the United States.

Autor:	Goedel WC; Department of Epidemiology, School of Public Health, Brown University, Providence, RI., Rogers BG; Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI., Li Y; Department of Epidemiology, School of Public Health, Brown University, Providence, RI., Nunn AS; Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI., Patel RR; Department of Internal Medicine, School of Medicine, Washington University in Saint Louis, Saint Louis, MO., Marshall BDL; Department of Epidemiology, School of Public Health, Brown University, Providence, RI., Mena LA; Department of Population Health Sciences, University of Mississippi Medical Center, Jackson, MS; and., Ward LM; Department of Population Health Sciences, University of Mississippi Medical Center, Jackson, MS; and., Brock JB; Department of Population Health Sciences, University of Mississippi Medical Center, Jackson, MS; and., Napoleon S; Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI., Zanowick-Marr A; Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI., Curoe K; Department of Internal Medicine, School of Medicine, Washington University in Saint Louis, Saint Louis, MO., Underwood A; Department of Internal Medicine, School of Medicine, Washington University in Saint Louis, Saint Louis, MO., Johnson CJ; Department of Population Health Sciences, University of Mississippi Medical Center, Jackson, MS; and., Lockwood KR; Department of Population Health Sciences, University of Mississippi Medical Center, Jackson, MS; and., Chan PA; Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI.; Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI.
Jazyk:	angličtina
Zdroj:	Journal of acquired immune deficiency syndromes (1999) [J Acquir Immune Defic Syndr] 2022 Oct 01; Vol. 91 (2), pp. 151-156.
DOI:	10.1097/QAI.0000000000003042
Abstrakt:	Background: The coronavirus disease 2019 (COVID-19) pandemic continues to put strain on health systems in the United States, leading to significant shifts in the delivery of routine clinical services, including those offering HIV pre-exposure prophylaxis (PrEP). We aimed to assess whether individuals discontinued PrEP use at higher rates during the COVID-19 pandemic and the extent to which disruptions to usual clinical care were mitigated through telehealth. Methods: Using data from an ongoing prospective cohort of men who have sex with men (MSM) newly initiating PrEP in 3 mid-sized cities (n = 195), we calculated the rate of first-time discontinuation of PrEP use in the period before the COVID-19 pandemic and during the COVID-19 pandemic and compared these rates using incidence rate ratios (IRRs). Furthermore, we compared the characteristics of patients who discontinued PrEP use during these periods with those who continued to use PrEP during both periods. Results: Rates of PrEP discontinuation before the COVID pandemic and during the COVID-19 pandemic were comparable [4.29 vs. 5.20 discontinuations per 100 person-months; IRR: 1.95; 95% confidence interval (CI): 0.83 to 1.77]. Although no significant differences in the PrEP discontinuation rate were observed in the overall population, the rate of PrEP discontinuation increased by almost 3-fold among participants aged 18-24 year old (IRR: 2.78; 95% CI: 1.48 to 5.23) and by 29% among participants covered by public insurance plans at enrollment (IRR: 1.29; 95% CI: 1.03 to 5.09). Those who continued to use PrEP were more likely to have had a follow-up clinical visit by telehealth in the early months of the pandemic (45% vs. 17%). Conclusions: In this study, rates of PrEP discontinuation were largely unchanged with the onset of the COVID-19 pandemic. The use of telehealth likely helped retain patients in PrEP care and should continue to be offered in the future. Competing Interests: Supported by a grant from the National Institute of Mental Health (R01MH114657; MPI: P.A.C. and A.S.N.). B.G.R. has received research project funds from Gilead Sciences, Inc. L.A.M. has received consulting fees and speaker fees from Gilead Sciences, Inc.; GlaxoSmithKline, LLC; Merck Sharp & Dohme Corporation; Roche Molecular Systems, Inc.; Theratechnologies, Inc.; and ViiV Health Healthcare Company. R.R.P. has received consulting fees from Gilead Sciences, Inc. and ViiV Healthcare Company. The remaining authors have no conflicts of interest to disclose. (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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