Hill Nina E, He Sijia, Chua Kao-Ping
Susan B Meister Child Health Evaluation and Research Center, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA.
Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
J Gen Intern Med. 2025 May 9. doi: 10.1007/s11606-025-09574-8.
U.S. young adults account for a disproportionate share of new HIV diagnoses. Despite this, no national study has examined recent trends in HIV pre-exposure prophylaxis (PrEP) dispensing to this age group.
To assess trends in PrEP dispensing to young adults from 2016 to 2023.
Cross sectional study of the IQVIA Longitudinal Prescription Database.
Young adults aged 18-25 years.
Quarterly PrEP dispensing rate (number of young adults with dispensed PrEP prescriptions per 100,000 U.S. young adults), quarterly PrEP initiation rate (number of young adults with a new dispensed PrEP prescription per 100,000 U.S. young adults), and quarterly mean PrEP persistence (number of days with an active PrEP prescription in the 180 days after the new PrEP prescription ended among those initiating therapy). Joinpoint regression was used to identify slope changes and calculate the quarterly percent change (QPC). Subgroup analyses were conducted by age group.
Analyses included 1,450,296 PrEP prescriptions dispensed between January 1, 2016-December 31, 2023 to 239,780 young adults. The quarterly PrEP dispensing rate increased sharply between 2016-2018, from 26.4 to 100.7 prescriptions per 100,000 people (QPC: 12.5%, 95% CI: 10.0 to 15.1). Afterwards, this rate increased gradually to 208.4 prescriptions per 100,000 people in 2023 (QPC: 3.5%, 95% CI: 2.7 to 4.3). Trends in the quarterly PrEP initiation rate were qualitatively similar. From 2016 to 2023, quarterly mean persistence decreased from 111.6 to 98.4 days (QPC: -0.4%, 95% CI: -0.6, -0.2). Compared with patients aged 22-25 years, those aged 18-21 years had lower quarterly PrEP dispensing and initiation rates throughout 2016-2023. Persistence was lower in these younger patients in 2016, but the gap narrowed over time.
Dispensing and initiation of PrEP among young adults is increasing, but treatment episodes are shortening. Efforts to promote retention in therapy are needed.
美国青年成年人中新发艾滋病毒诊断病例所占比例过高。尽管如此，尚无全国性研究调查过向该年龄组提供艾滋病毒暴露前预防（PrEP）药物的近期趋势。
评估2016年至2023年期间向青年成年人提供PrEP药物的趋势。
对IQVIA纵向处方数据库进行的横断面研究。
年龄在18至25岁之间的青年成年人。
季度PrEP药物配给率（每10万名美国青年成年人中获得PrEP处方的青年成年人数量）、季度PrEP起始率（每10万名美国青年成年人中获得新PrEP处方的青年成年人数量）以及季度平均PrEP持续时间（在开始治疗的人群中，新PrEP处方结束后的180天内有有效PrEP处方的天数）。采用Joinpoint回归来识别斜率变化并计算季度百分比变化（QPC）。按年龄组进行亚组分析。
分析纳入了2016年1月1日至2023年12月31日期间向239,780名青年成年人发放的1,450,296份PrEP处方。2016 - 2018年期间，季度PrEP药物配给率急剧上升，从每10万人26.4份处方增至100.7份处方（QPC：12.5%，95%CI：10.0至15.1）。此后，该比率逐渐上升至2023年的每10万人208.4份处方（QPC：3.5%，95%CI：2.7至4.3）。季度PrEP起始率的趋势在性质上相似。2016年至2023年期间，季度平均持续时间从111.6天降至98.4天（QPC：-0.4%，95%CI：-0.6，-0.2）。与22 - 25岁的患者相比，18 - 21岁的患者在2016 - 2023年期间的季度PrEP药物配给率和起始率较低。2016年这些较年轻患者的持续时间较短，但随着时间推移差距缩小。
青年成年人中PrEP药物的配给和起始率在增加，但治疗疗程在缩短。需要努力促进治疗的持续进行。
