Majority of PrEP Users Do Not Maintain Adherence

A large study showed that a majority of people who are using PrEP either discontinued use or did not have full adherence within 6 months of beginning a regimen.

In the former group, 40.2% was the discontinuation rate, and a majority of them were in specific groups.

“Studies observing an HIV incidence higher than 0.5/100 person-years among PrEP users reported a higher discontinuation rate (32.2% vs 28.3%, 15 studies vs 23 studies, P=0.022),” the investigators reported. “Gay, bisexual and other men who have sex with men who were only offered daily dosing had a higher discontinuation rate than those who had options for daily or nondaily dosing (33.0% vs 16.9%, 33 studies vs five studies, P<0.001).”

For the latter group, 36.8% were reported to have remained on the medication, but did not have full adherence.

Investigators looking at 58 longitudinal studies reporting discontinuation of PrEP with 43,639 individuals across 20 countries. This systematic review and meta-analysis aim to synthesize the estimated rates of PrEP discontinuation, inadequate adherence among those who continued, and re-initiation among those who discontinued, across key populations and summarize the potential reasons and correlates related to PrEP discontinuation,” the investigators wrote.

There was an encouraging trend of reengagement of the therapy. Among those who discontinued, 40 percent restarted PrEP within 7 to 12months. Thus showing many users see the value in it, but also that there will be starts and stops for this type of therapy.

This also offers an opportunity to reengage discussions and counseling on the topic.

“Strategies to encourage reinitiating PrEP for new or persistent risk should be a focus of future PrEP implementation,” the investigators concluded.

The findings were presented at the 11th International AIDS Society Conference on HIV Science.