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Defining HIV Pre-Exposure Prophylaxis (PrEP) Persistence: A Scoping Review.

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This summary is machine-generated.

Understanding patterns of pre-exposure prophylaxis (PrEP) use is crucial for assessing program effectiveness. This review highlights inconsistent definitions of PrEP persistence, impacting study comparisons and public health policy.

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Area of Science:

  • Public Health
  • Infectious Disease Prevention
  • HIV/AIDS Research

Background:

  • Assessing pre-exposure prophylaxis (PrEP) effectiveness requires understanding PrEP use patterns.
  • Continued PrEP use, termed 'persistence,' lacks consistent definition, affecting study interpretation and policy.
  • This scoping review aimed to describe and compare existing definitions of PrEP persistence.

Purpose of the Study:

  • To systematically review and compare definitions of PrEP persistence used in scientific literature.
  • To identify common methodologies and variations in defining PrEP persistence.
  • To inform consistent reporting and interpretation of PrEP effectiveness studies.

Main Methods:

  • Conducted a comprehensive literature search across PubMed, Embase, Scopus, and Global Health (2012-2026).
  • Included studies discussing longitudinal anti-HIV agents for HIV prevention, using keywords related to HIV, prevention, and persistence.
  • Screened abstracts, reviewed full-text articles, and extracted data on persistence definitions, performed by two independent investigators.

Main Results:

  • Analyzed 147 studies, with 29% providing only qualitative persistence definitions.
  • Among studies with operational definitions (71%), 76% used prescription refill/clinic visit dates, and 57% relied solely on these.
  • Adherence measures were included in 28% of operational definitions, with 11% relying exclusively on adherence.

Conclusions:

  • Definitions of PrEP persistence are highly heterogeneous across studies.
  • Most definitions consider engagement with PrEP services, but adherence measures are also frequently used.
  • This heterogeneity complicates cross-study comparisons and public health decision-making regarding PrEP interventions.