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Optimizing HIV PrEP Persistence: Does Your Pharmacy Matter?

Kristen Whelchel1, Autumn D Zuckerman2, Josh DeClercq3

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Summary
This summary is machine-generated.

Integrated health-system specialty pharmacy (HSSP) improves adherence to human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP). Patients filling PrEP through HSSP demonstrated significantly higher persistence rates compared to those using external pharmacies.

Keywords:
Anti-HIV agentsPersistencePre-exposure prophylaxisSpecialty pharmacy

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Area of Science:

  • Public Health
  • Pharmacoepidemiology
  • Infectious Disease Prevention

Background:

  • Adherence to human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) is critical for preventing new HIV infections.
  • Real-world PrEP adherence remains suboptimal, necessitating research into effective delivery strategies.
  • Integrated health-system specialty pharmacies (HSSP) may offer a novel approach to enhance PrEP adherence.

Purpose of the Study:

  • To compare PrEP persistence between patients utilizing an integrated health-system specialty pharmacy (HSSP) and those using external pharmacies.
  • To identify factors influencing PrEP persistence in a real-world setting.

Main Methods:

  • Retrospective cohort study at a single center.
  • Comparison of PrEP persistence based on pharmacy type (HSSP vs. external).
  • Kaplan-Meier survival analysis and Cox proportional hazards modeling were used to assess persistence.

Main Results:

  • Patients filling PrEP through HSSP showed significantly higher persistence probabilities at 6, 12, and 18 months compared to the non-HSSP cohort (e.g., 18-month persistence: 0.64 vs. 0.32).
  • Log-rank test indicated a significant difference in persistence between the two groups (p < 0.001).
  • Cox PH modeling revealed that using a non-HSSP was associated with a 2.7-fold increased likelihood of non-persistence (HR 2.7, p < 0.001).

Conclusions:

  • Dispensing PrEP through an integrated health-system specialty pharmacy is associated with substantially improved patient persistence.
  • HSSP models represent a promising strategy for enhancing adherence to PrEP and optimizing HIV prevention efforts.