دورية أكاديمية
Adherence to daily HIV pre-exposure prophylaxis in a large-scale implementation study in New South Wales, Australia
| العنوان: | Adherence to daily HIV pre-exposure prophylaxis in a large-scale implementation study in New South Wales, Australia |
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| المؤلفون: | Jin, F, Amin, J, Guy, R, Vaccher, S, Selvey, C, Zablotska, I, Holden, J, Price, K, Yeung, B, Ogilvie, E, Quichua, GC, Clackett, S, McNulty, A, Smith, D, Templeton, DJ, Bavinton, B, Grulich, AE |
| المصدر: | urn:ISSN:0269-9370 ; urn:ISSN:1473-5571 ; AIDS, 35, 12, 1987-1996 |
| بيانات النشر: | Wolters Kluwer |
| سنة النشر: | 2021 |
| المجموعة: | UNSW Sydney (The University of New South Wales): UNSWorks |
| مصطلحات موضوعية: | Infectious Diseases, Prevention, HIV/AIDS, Clinical Research, Infection, 3 Good Health and Well Being, Adolescent, Adult, Aged, 80 and over, Anti-HIV Agents, Australia, Female, HIV Infections, Humans, Male, Middle Aged, New South Wales, Pre-Exposure Prophylaxis, Young Adult, Expanded PrEP Implementation in Communities New South Wales (EPIC-NSW) research group, anzsrc-for: 06 Biological Sciences, anzsrc-for: 11 Medical and Health Sciences, anzsrc-for: 17 Psychology and Cognitive Sciences |
| الوصف: | Objectives:To examine patterns of long-term pre-exposure prophylaxis (PrEP) adherence and its association with HIV seroconversion in NSW, Australia.Design:Population-based HIV PrEP implementation study.Methods:Expanded PrEP Implementation in Communities in New South Wales was an open-label study of daily oral PrEP which recruited participants from March 2016 to April 2018. Adherence was measured using dispensing records. PrEP discontinuation was defined as an at least 120-day period without PrEP coverage. Long-term adherence patterns were identified using group-based trajectory modelling.Results:Participants dispensed at least once (n = 9586) were almost all male (98.5%), identified as gay (91.3%), with a median age of 34 years (range: 18-86). Of the 6460 (67.4%) participants who had at least 9 months of follow-up since first dispensing, 1942 (30.1%) discontinued. Among these, 292 (15.0%) restarted later. Four distinct groups were identified ['Steep decline' in adherence (15.8%), 'Steady decline' (11.6%), 'Good adherence' (37.4%), and 'Excellent adherence' (35.2%)]. Older (P < 0.001) and gay-identified (P < 0.001) participants were more likely to have higher adherence, so were those living in postcodes with a higher proportion of gay-identified male residents (P < 0.001). Conversely, those who at baseline reported recent crystal methamphetamine use and had a recent diagnosis of sexually transmitted infection (STI) had lower adherence (P < 0.001). Overall HIV incidence was 0.94 per 1000 person-years (95% confidence interval: 0.49-1.81; n = 9) and was highest in the 'steep decline' group (5.45 per 1000 person-years; P = 0.001).Conclusion: About 15% of participants stopped PrEP during study follow-up and were at increased risk of HIV infection. They were more likely to be younger and report a recent STI or methamphetamine use prior to PrEP initiation. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | unknown |
| العلاقة: | http://purl.org/au-research/grants/nhmrc/APP1173931Test; http://hdl.handle.net/1959.4/unsworks_81237Test; https://doi.org/10.1097/QAD.0000000000002970Test |
| DOI: | 10.1097/QAD.0000000000002970 |
| الإتاحة: | https://doi.org/10.1097/QAD.0000000000002970Test http://hdl.handle.net/1959.4/unsworks_81237Test |
| حقوق: | metadata only access ; http://purl.org/coar/access_right/c_14cbTest ; CC-BY-NC-ND ; https://creativecommons.org/licenses/by-nc-nd/4.0Test/ |
| رقم الانضمام: | edsbas.F88951B6 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1097/QAD.0000000000002970 |
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