Continuation of HIV Pre-Exposure Prophylaxis (PrEP) is key to realising its public health benefit. This study sought to evaluate retention in care amongst individuals receiving a prescription of PrEP from our large level 3 integrated sexual health service in the north east of England.
Methods
We identified all patients prescribed PrEP between 01.01.21 and 31.12.21 using GUMCAD2 coding. Results were cross-checked against PrEP clinic attendances and duplicates excluded. We assessed retention in care at 3, 6 and 9 months following the first PrEP prescription.
Results
402 patients were prescribed PrEP during the study period. Nearly all were men who have sex with men (98%) with a median age of 30 (range 17-77). Two thirds lived locally to our clinic. 239 patients reported no previous PrEP use, 109 were IMPACT PrEP participants (IPP) and 61 had previously sourced PrEP by another means. Overall continuation was 75%, 68% and 61% at 3, 6 and 9 months respectively. Univariate analysis reveals retention in care was greater amongst IPP compared with new-starters (3 months 83% v 74% p=0.09; 6 months 76% v 61% p=0.02; 9 months 74% v 45% p=0.0009).
Discussion
61% of patients prescribed HIV PrEP remained in care at 9 months, with a higher proportion lost to follow-up amongst new starters. Whilst patients might have accessed other services, higher retention rates amongst IPP could reflect higher perceived value of PrEP (associated with HIV risk, access or normalisation) or a need to better support new users, warranting further evaluation.
'%3e%3cpath fill='%23012169' d='M0 0v30h60V0z'/%3e%3cpath stroke='%23fff' stroke-width='6' d='m0 0 60 30m0-30L0 30'/%3e%3cpath stroke='%23C8102E' stroke-width='4' d='m0 0 60 30m0-30L0 30' clip-path='url(%23b)'/%3e%3cpath stroke='%23fff' stroke-width='10' d='M30 0v30M0 15h60'/%3e%3cpath stroke='%23C8102E' stroke-width='6' d='M30 0v30M0 15h60'/%3e%3c/g%3e%3c/svg%3e)
'/%3e%3c/defs%3e%3cpath fill='%23012169' d='M0 0h10080v5040H0z'/%3e%3cpath stroke='%23fff' stroke-width='.6' d='m0 0 6 3m0-3L0 3' clip-path='url(%23b)' transform='scale(840)'/%3e%3cpath stroke='%23e4002b' stroke-width='.4' d='m0 0 6 3m0-3L0 3' clip-path='url(%23c)' transform='scale(840)'/%3e%3cpath stroke='%23fff' stroke-width='840' d='M2520 0v2520M0 1260h5040'/%3e%3cpath stroke='%23e4002b' stroke-width='504' d='M2520 0v2520M0 1260h5040'/%3e%3cg fill='%23fff'%3e%3cuse xlink:href='%23d' x='2520' y='3780'/%3e%3cuse xlink:href='%23a' x='7560' y='4200'/%3e%3cuse xlink:href='%23a' x='6300' y='2205'/%3e%3cuse xlink:href='%23a' x='7560' y='840'/%3e%3cuse xlink:href='%23a' x='8680' y='1869'/%3e%3cuse xlink:href='%23e' x='8064' y='2730'/%3e%3c/g%3e%3c/svg%3e)