圣地亚哥 HIV 初级保健诊所中高危患者接受 PrEP 保留的预测因素。
Predictors of PrEP retention in at risk patients seen at a HIV primary care clinic in San Diego.
机构信息
University of California San Diego, San Diego, CA, USA.
University of Massachusetts, Chan Medical School, Worcester, MA, USA.
出版信息
Int J STD AIDS. 2023 Oct;34(11):785-790. doi: 10.1177/09564624231179276. Epub 2023 Jun 4.
BACKGROUND
Adherence to medication and retention in care are key contributors to the efficacy of pre-exposure prophylaxis (PrEP) for prevention of HIV. Therefore, it is important to understand factors that may impact retention in various settings that prescribe PrEP.
METHODS
We evaluated factors associated with retention in care 3 and 12 months after PrEP initiation at a primary care HIV clinic in San Diego. Retention was defined as having an office/virtual visit within 1 month from the 3- or 12-months time point or interacting with the clinic leading to medication being refilled.
RESULTS
A total of 199 patients were included. Retention rates were 74.4% and 52.8% at 3 and 12 months respectively. In the multivariate analysis, reporting depression or anxiety was associated with being retained in care ( = 0.004) and identifying as cisgender female was associated with lack of retention ( = 0.04) at 3 months. Testing positive for a sexually transmitted infection was associated with 12-months retention ( = 0.004); however, this was likely influenced by difference in the frequency of testing in those retained versus not retained.
CONCLUSION
Ongoing efforts to determine the optimal method for provision of PrEP care that supports retention for different populations at risk for HIV, are needed.
背景
药物依从性和治疗保留率是影响暴露前预防（PrEP）预防 HIV 效果的关键因素。因此，了解可能影响不同环境下 PrEP 开具保留率的因素非常重要。
方法
我们评估了在圣地亚哥的一家初级保健 HIV 诊所中，在开始 PrEP 后 3 个月和 12 个月时与保留治疗相关的因素。保留治疗定义为在 3 个月或 12 个月时间点后 1 个月内进行一次办公室/虚拟就诊，或与诊所互动导致药物续开。
结果
共纳入 199 名患者。3 个月和 12 个月时的保留率分别为 74.4%和 52.8%。在多变量分析中，报告抑郁或焦虑与保留治疗相关（ = 0.004），而性别认同为 cisgender 女性与 3 个月时保留治疗失败相关（ = 0.04）。性传播感染检测阳性与 12 个月的保留治疗相关（ = 0.004）；然而，这可能受到保留组和未保留组检测频率差异的影响。
结论
需要不断努力确定为不同 HIV 风险人群提供支持保留治疗的 PrEP 护理的最佳方法。
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