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Uptake and Persistent Use of HIV Preexposure Prophylaxis Among Key Populations: Results From Ukraine's Scaled

Olga Vitruk1, Alyona P Ihnatiuk2, Anna P Kazanzhy2

  • 1Department of Epidemiology, University of Washington, Seattle, WA.

Journal of Acquired Immune Deficiency Syndromes (1999)
|June 21, 2024
PubMed

Insights

HIV pre-exposure prophylaxis (PrEP) persistence was low in Ukraine, particularly among men who have sex with men and sex workers. Further research is needed to understand barriers to PrEP use in key populations.

Area of Science:

  • Public Health
  • Infectious Disease Epidemiology
  • HIV Prevention

Background:

  • Ukraine has established HIV prevention programs since 1999.
  • Pre-exposure prophylaxis (PrEP) was introduced in Ukraine in 2017.
  • Limited data exists on PrEP uptake and persistence in Ukraine.

Purpose of the Study:

  • To evaluate PrEP persistence among key populations in Ukraine.
  • To identify factors influencing PrEP retention in HIV prevention efforts.

Main Methods:

  • Analysis of data from 40 facilities in Ukraine (Oct 2020 - Feb 2022).
  • Kaplan-Meier and Cox regression analyses were used to estimate PrEP retention and discontinuation.
  • Stratification by sex, age, and key populations (KPs): men who have sex with men (MSM), people who inject drugs (PWID), sex workers (SW), and discordant couples/others (DC/other).

Main Results:

  • 2033 clients initiated PrEP; majority were DC/other (51%), MSM (22%), PWID (22%), and SW (5%).
  • Overall 3-month PrEP persistence was 52.3%, lowest among SW (25.9%) and MSM (46.7%).
  • After age adjustment, discontinuation risk did not significantly differ by KP group, though female PWID had lower risk and male SW had higher risk.

Conclusions:

  • Three-month PrEP persistence was low across key populations, with notable challenges for sex workers.
  • Further investigation into barriers and facilitators of PrEP persistence among key populations is crucial.
Abstract

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