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Oral preexposure prophylaxis continuation, measurement and reporting
Kayla Stankevitz1, Hannah Grant2, Josie Lloyd
1FHI 360, Durham, North Carolina, USA.
AIDS (London, England)
|June 20, 2020
Summary
Oral pre-exposure prophylaxis (PrEP) continuation is crucial for effectiveness. This review found high early discontinuation and inconsistent reporting, highlighting a need for standardized measurement of PrEP use.
Area of Science:
- Public Health
- Infectious Disease Epidemiology
- HIV Prevention
Background:
- Oral pre-exposure prophylaxis (PrEP) is a key strategy for HIV prevention.
- Understanding PrEP continuation is vital for effective rollout and impact monitoring.
- Current methods for measuring PrEP continuation lack standardization.
Purpose of the Study:
- To review and analyze data on PrEP continuation.
- To document how PrEP continuation is reported across studies.
- To compare PrEP continuation rates over time and across different populations.
Main Methods:
- Systematic review and meta-analysis of studies reporting primary data on PrEP continuation.
- Searched MEDLINE, Embase, Global Health, and HIV conference abstracts (2017-2018).
- Summarized findings along a PrEP cascade, presenting continuation at 1, 6, and 12 months.
Main Results:
- 41 studies covering 22,034 individuals were included.
- Continuation data were measured and reported inconsistently.
- High discontinuation was observed at month 1 (66%), with persistent declines over time. Pooled estimates: Month 1: 66%, Month 6: 63%, Month 12: 71%.
Conclusions:
- High early discontinuation suggests PrEP initiation alone is insufficient to gauge effectiveness.
- Declining continuation over time indicates limitations of current cross-sectional indicators.
- There is a critical need for consistent measurement and consensus on PrEP continuation.
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