Physicians who prescribe Truvada (tenofovir/emtricitabine) as pre-exposure prophylaxis (PrEP) to men who have sex with men (MSM) may face a challenge keeping them returning to the quarterly visits needed to maintain the prescription. Publishing their findings in the Journal of the International AIDS Society, researchers collected data on 267 people prescribed Truvada as prevention in three PrEP programs: in Providence, Rhode Island (117 people); Jackson, Mississippi (88 people); and St. Louis, Missouri (62 people).
Overall, 81 percent of the cohort filled a Truvada prescription, including 73 percent in Providence, 82 percent in Jackson and 94 percent in St. Louis. A respective 7 percent, 72 percent and 26 percent were African American. A respective 24 percent, 2 percent and 3 percent were Latino. The respective proportion living below the poverty line was 26 percent, 52 percent and 23 percent. MSM constituted a respective 92 percent, 88 percent and 84 percent of the cohorts. The proportion of MSM reporting condomless sex was a respective 70 percent, 65 percent and 75 percent.
Among 171 individuals prescribed PrEP at least six months prior, 72 percent remained in care after three months, including 68 percent in Providence, 70 percent in Jackson and 87 percent in St. Louis. Fifty-seven percent were in care after six months, including a respective 53 percent, 61 percent and 63 percent, broken down by city.
Insurance status and medication costs were not found to be barriers to obtaining PrEP.
Three people (1.1 percent) tested positive for HIV during the six-month period after receiving a PrEP prescription, including one in Providence who is suspected to have been acutely infected at the outset but initially tested false negative, one in St. Louis who adhered poorly to the daily Truvada regimen and one in Jackson who contracted HIV just before starting Truvada.
The study authors concluded: “PrEP initiation and retention in care differed across these distinct settings. In contrast, retention in PrEP care was consistently suboptimal across sites. Further research is needed to identify the individual, social and structural factors that may impede or enhance retention in PrEP care.”
To read the study, click here.