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Understanding Typology of Preexposure Prophylaxis (PrEP) Persistence Trajectories Among Male PrEP Users in the United States.

Publication ,  Journal Article
Chen, Y-N; Zhou, J; Kirkham, HS; Witt, EA; Jenness, SM; Wall, KM; Kamaleswaran, R; Naimi, AI; Siegler, AJ
Published in: Open Forum Infect Dis
November 2024

INTRODUCTION: Understanding longitudinal patterns of preexposure prophylaxis (PrEP) use among men who have sex with men could offer insights for developing efficient and timely interventions to promote PrEP persistence. SETTING: We extracted 2 years of pharmacy fill records for 4000 males who initiated PrEP in 2017 at a national chain pharmacy in the United States. METHODS: Group-based trajectory models were used to develop PrEP trajectory clusters, with periods of use defined based on optimal PrEP seroprotection probabilities (ie, PrEP use frequency ≥4 doses/week). Multinomial logistic regressions were used to evaluate the associations between sociodemographic covariates and identified trajectory group membership. RESULTS: We identified 4 distinct groups of PrEP persistence trajectories: (1) persistent use of PrEP throughout the period (persistent user), (2) brief use followed by sustained cessation of PrEP use (brief user), (3) PrEP use up to the mid-term followed by sustained cessation of PrEP use (mid-term user), and (4) PrEP use, followed by cessation and subsequent reinitiation (PrEP reinitiator). Persistent users and brief users accounted for 40.1% and 22.9% of the population, respectively, whereas mid-term users and reinitiators accounted for 18.9% and 18.2%, respectively. Older age at PrEP initiation, commercial insurance as the primary payer of PrEP, and use of specialty pharmacy were found to be associated with persistent PrEP use over the other patterns of nonpersistence. CONCLUSIONS: Subgroups of PrEP users could benefit from PrEP persistence interventions that target specific timings of likely PrEP cessation or considerations of reinitiation.

Duke Scholars

Published In

Open Forum Infect Dis

DOI

ISSN

2328-8957

Publication Date

November 2024

Volume

11

Issue

11

Start / End Page

ofae584

Location

United States

Related Subject Headings

  • 3207 Medical microbiology
  • 3202 Clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
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Chen, Y.-N., Zhou, J., Kirkham, H. S., Witt, E. A., Jenness, S. M., Wall, K. M., … Siegler, A. J. (2024). Understanding Typology of Preexposure Prophylaxis (PrEP) Persistence Trajectories Among Male PrEP Users in the United States. Open Forum Infect Dis, 11(11), ofae584. https://doi.org/10.1093/ofid/ofae584
Chen, Yi-No, Junlan Zhou, Heather S. Kirkham, Edward A. Witt, Samuel M. Jenness, Kristin M. Wall, Rishi Kamaleswaran, Ashley I. Naimi, and Aaron J. Siegler. “Understanding Typology of Preexposure Prophylaxis (PrEP) Persistence Trajectories Among Male PrEP Users in the United States.Open Forum Infect Dis 11, no. 11 (November 2024): ofae584. https://doi.org/10.1093/ofid/ofae584.
Chen Y-N, Zhou J, Kirkham HS, Witt EA, Jenness SM, Wall KM, et al. Understanding Typology of Preexposure Prophylaxis (PrEP) Persistence Trajectories Among Male PrEP Users in the United States. Open Forum Infect Dis. 2024 Nov;11(11):ofae584.
Chen, Yi-No, et al. “Understanding Typology of Preexposure Prophylaxis (PrEP) Persistence Trajectories Among Male PrEP Users in the United States.Open Forum Infect Dis, vol. 11, no. 11, Nov. 2024, p. ofae584. Pubmed, doi:10.1093/ofid/ofae584.
Chen Y-N, Zhou J, Kirkham HS, Witt EA, Jenness SM, Wall KM, Kamaleswaran R, Naimi AI, Siegler AJ. Understanding Typology of Preexposure Prophylaxis (PrEP) Persistence Trajectories Among Male PrEP Users in the United States. Open Forum Infect Dis. 2024 Nov;11(11):ofae584.
Journal cover image

Published In

Open Forum Infect Dis

DOI

ISSN

2328-8957

Publication Date

November 2024

Volume

11

Issue

11

Start / End Page

ofae584

Location

United States

Related Subject Headings

  • 3207 Medical microbiology
  • 3202 Clinical sciences