In two research papers published by the AIDS and Behavior journal, a team of Northwestern University researchers report Chicago-specific data on PrEP uptake and discontinuation among gay and bisexual men.
The first paper, titled “Threefold Increase in PrEP Uptake Over Time with High Adherence Among Young Men Who Have Sex with Men in Chicago,” reports a PrEP uptake of 6.6 percent to 17.5 percent from 2015 to 2017. Increases were significant among white and Latinx participants, but not among black young men who have sex with men. About 80 percent of PrEP users reported being more than 90 percent adherent. If you put these estimates into the Jenness model of PrEP impact and assume 20 percent HIV prevalence, the model estimates that about 20 percent of HIV infections are being averted. Doubling intake to 40 percent coverage would avert 35 percent of infections. Past six-month PrEP use was significantly associated with participation in condomless sex, having more sexual partners, and older age. As PrEP uptake continues to rise, more research will be needed to understand predictors of PrEP usage, as well as patterns of sexual behavior change following uptake.
The second paper, titled “High Rate of Discontinuation May Diminish PrEP Coverage Among Young Men Who have Sex with Men,” reports on PrEP discontinuation among the 197 young men who have sex with men who reported using PrEP within the cohort. Thirty-three percent of the participants who used PrEP had discontinued by the time of an interview. Black and Latinx participants were more likely to discontinue and 79 percent percent of those who discontinued never spoke to a doctor about doing so. Risk behaviors continued after stopping PrEP. The most common reasons for discontinuing were “trouble getting to doctor’s appointment” (21.5 percent), “insurance not covering it” (20 percent), and “not feeling at risk for HIV” (18.5 percent). These data suggest that PrEP discontinuation must be given more attention to optimally prevent HIV.
More information about these articles, including access options, can be found at the SpringerLink website.