Patterns and correlates of participant retention in a multi-city pre-exposure prophylaxis demonstration project

Susanne Doblecki-Lewis, Albert Y. Liu, Daniel J. Feaster, Stephanie E. Cohen, Richard Elion, Oliver Bacon, Megan Coleman, Gabriel Cardenas, Michael A. Kolber

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Background: Safe and effective use of pre-exposure prophylaxis (PrEP) depends on retention in care after initial engagement. Setting: The United States PrEP Demonstration Project offered daily oral tenofovir/emtricitabine to participants in San Francisco, Miami, and Washington, D.C. for 48 weeks from 2012 to 2014. Methods: The Demo Project participants' patterns of retention were assigned to 1 of 3 categories: Early loss to follow-up (ELTF) within the first 12 weeks of the study, retention throughout the study, or intermittent retention in which missed or delayed visits resulted in gaps in medication availability. For each group, baseline characteristics were tabulated. A two-step multivariable analysis was performed. Results: Overall, 366/554 (66.1%) of enrolled participants were retained for all study visits, 127/554 (22.9%) had intermittent retention, and 61/554 (11.0%) ELTF. In multivariable analysis, Miami compared with San Francisco site was associated with ELTF rather than full retention [aOR 2.84; confidence interval (CI): 1.24 to 6.47] and also with intermittent rather than full retention (aOR 2.70; CI: 1.43 to 5.11). Younger age was associated with ELTF (aOR 1.80 for each 10-year decrement in age; CI: 1.26 to 2.57) and intermittent retention (aOR 1.47; CI: 1.17 to 1.84) compared with full retention. Factors associated with ELTF (but not intermittent retention) compared with full retention were black compared with white (aOR 3.32; CI: 1.09 to 10.16), reporting sex work (aOR 4.67; CI: 1.49 to 14.58), lack of regular employment (aOR 2.53; CI: 1.27 to 5.05), and lack of previous PrEP awareness (aOR 2.01; CI: 1.01 to 3.96). Conclusions: Tailored interventions addressing causes and risk factors for loss from PrEP care may improve retention and consistency of PrEP use.

Original languageEnglish (US)
Pages (from-to)62-69
Number of pages8
JournalJournal of Acquired Immune Deficiency Syndromes
Volume79
Issue number1
DOIs
StatePublished - Sep 1 2018

Keywords

  • HIV prevention
  • demonstration project
  • men who have sex with men
  • pre-exposure prophylaxis
  • retention-in-care

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

Fingerprint Dive into the research topics of 'Patterns and correlates of participant retention in a multi-city pre-exposure prophylaxis demonstration project'. Together they form a unique fingerprint.

  • Cite this