Understanding Retention in Pre-Exposure Prophylaxis Care in the South: Insights from an Academic HIV Prevention Clinic.

Journal Article (Journal Article)

HIV pre-exposure prophylaxis (PrEP) is poorly utilized in the southern United States. We examined PrEP retention in care and sexually transmitted infections (STIs) through a retrospective review of the Duke University PrEP Clinic from January 1, 2015 to October 15, 2019. We evaluated short-term (3 months), long-term (additional 8-12 months), and longitudinal retention in care in our clinic. Adjusted odds ratios (aOR) were generated to explore demographics associated with retention. Kaplan-Meier curves were generated to view retention longitudinally. STIs were examined at baseline (1 year before initial PrEP visit) and while retained in care. Of a total of 255 patients; 88% were men, 37% were black, and 73% were men who have sex with men (MSM). Short- and long-term retention in care were met by 130/237 (55%) and 80/217 (37%) patients, respectively. MSM were more likely to be retained in the short term (aOR = 5.22, 95% confidence interval [CI] = 1.57-17.32). Self-referred patients were more likely to be retained in the long term (aOR = 2.18, 95% CI = 1.12-4.23). Uninsured patients were less likely to be retained in the long term (aOR = 0.32, 95% CI = 0.11-0.91). STI diagnoses include 42 infections at baseline and 69 infections during follow-up. STI diagnosed while in PrEP care was associated with longer retention in care over time. Patients discontinue PrEP care over time and STIs were frequently encountered. Additional studies are needed to determine the best way to retain patients in HIV preventative care.

Full Text

Duke Authors

Cited Authors

  • Burns, CM; Borges, M; Frye, J; Keicher, K; Elliott, S; Schwartz, S; Shipp, K; Okeke, NL; McKellar, MS

Published Date

  • April 2022

Published In

Volume / Issue

  • 38 / 4

Start / End Page

  • 306 - 312

PubMed ID

  • 35172632

Pubmed Central ID

  • PMC9048170

Electronic International Standard Serial Number (EISSN)

  • 1931-8405

Digital Object Identifier (DOI)

  • 10.1089/AID.2021.0177


  • eng

Conference Location

  • United States