School of Public Health, Department of Epidemiology, Hans Rosling Center for Population Health, University of Washington, 3980 15th Ave NE, Seattle, WA, 98195, USA.
Centro San Vicente, El Paso, TX, USA.
J Racial Ethn Health Disparities. 2024 Dec;11(6):3537-3543. doi: 10.1007/s40615-023-01807-y. Epub 2023 Oct 3.
Latino men who have sex with men (MSM) experience disproportionately high rates of HIV diagnoses in the United States. Pre-exposure prophylaxis (PrEP) use is critical to reduce this inequity, but PrEP awareness, access, and use are low among Latino MSM. This study aims to describe patterns of PrEP persistence and discontinuation among predominately Latino MSM accessing PrEP in a federally qualified health center (FQHC) in El Paso, Texas.
This retrospective cohort comprised individuals who were eligible for PrEP at a FQHC in El Paso, Texas, between January 30, 2019, and August 15, 2021. We defined hierarchical categories of PrEP use and discontinuation, which was defined as more than 120 days between PrEP visits. We used Kaplan-Meier survival plots to estimate median time to first PrEP discontinuation.
There were 292 patients evaluated for PrEP; 91% were Latino. The majority of PrEP patients (70%, 205/292) experienced any PrEP discontinuation, and the median time to first PrEP discontinuation was 202 days (95% CI: 179-266). The proportion of patients who remained on PrEP at 3 months after initiation was 82% (95% CI: 76%, 87%) and at 6 months after initiation was 55% (95% CI: 46%, 62%).
While 3-month PrEP retention was high in this predominately Latino MSM patient population, PrEP discontinuation was common. Interventions that enhance longer-term persistence and support for restarting PrEP are needed to reduce the persistent ethnoracial disparities in HIV incidence.
在美国，与男性发生性关系的拉丁裔男性（MSM）的艾滋病毒诊断率不成比例地高。使用暴露前预防（PrEP）对于减少这种不平等至关重要，但拉丁裔 MSM 对 PrEP 的认识、获取和使用都很低。本研究旨在描述在德克萨斯州埃尔帕索的一家合格的联邦健康中心（FQHC）接受 PrEP 的主要是拉丁裔 MSM 中 PrEP 的持续使用和中断模式。
本回顾性队列包括 2019 年 1 月 30 日至 2021 年 8 月 15 日期间在德克萨斯州埃尔帕索的一家 FQHC 有资格接受 PrEP 的个体。我们定义了 PrEP 使用和中断的分层类别，中断定义为两次 PrEP 就诊之间超过 120 天。我们使用 Kaplan-Meier 生存图估计首次 PrEP 中断的中位时间。
有 292 名患者接受了 PrEP 评估；91%是拉丁裔。大多数 PrEP 患者（70%，205/292）经历了任何 PrEP 中断，首次 PrEP 中断的中位时间为 202 天（95%CI：179-266）。在开始使用 PrEP 后 3 个月时，仍有 82%（95%CI：76%，87%）的患者继续使用 PrEP，在开始使用 PrEP 后 6 个月时，仍有 55%（95%CI：46%，62%）的患者继续使用 PrEP。
虽然在这个主要是拉丁裔 MSM 患者群体中，3 个月的 PrEP 保留率很高，但 PrEP 的中断很常见。需要采取干预措施，以增强长期的持久性，并支持重新开始使用 PrEP，以减少在艾滋病毒发病率方面持续存在的种族差异。
