Yan Guo, City University of New York, New York, New York.
Drew A. Westmoreland, University of Florida, Gainesville, Florida.
Health Aff (Millwood). 2024 Mar;43(3):443-451. doi: 10.1377/hlthaff.2023.00867.
In the US, sexual and gender minority populations are disproportionately affected by HIV. Pre-exposure prophylaxis (PrEP) is a key prevention method, but its effectiveness relies on consistent usage. Our four-year national cohort study explored PrEP discontinuation among sexual and gender minority people who initiated PrEP. We found a high annual rate of discontinuation (35-40 percent) after PrEP initiation. Multivariable analysis with 6,410 person-years identified housing instability and prior history of PrEP discontinuation as predictors of discontinuation. Conversely, older age, clinical indication for PrEP, and having health insurance were associated with ongoing PrEP use. To promote sustained PrEP use, strategies should focus on supporting those at high risk for discontinuation, such as younger people, those without stable housing or health insurance, and prior PrEP discontinuers.
在美国，性少数群体和跨性别群体受 HIV 的影响不成比例。暴露前预防（PrEP）是一种重要的预防方法，但它的有效性依赖于持续使用。我们的四年全国队列研究探讨了开始接受 PrEP 的性少数群体和跨性别群体中 PrEP 的停药情况。我们发现，在开始接受 PrEP 后，每年的停药率很高（35-40%）。在有 6410 人年的多变量分析中，住房不稳定和之前的 PrEP 停药史是停药的预测因素。相反，年龄较大、PrEP 的临床适应证以及拥有健康保险与持续使用 PrEP 相关。为了促进持续使用 PrEP，策略应侧重于支持那些停药风险较高的人，如年轻人、没有稳定住房或健康保险的人以及之前停药的人。
