Health care disparities

How Does PrEP Use Differ Among Minority Patients?

The use pre-exposure prophylaxis (PrEP) among patients of racial and ethnic minorities is typically sustained, but many use PrEP short‑term or decreasingly, according to the results of a recent study.

To describe the use of PrEP in various racial and ethnic minority groups at a federally qualified health center in Chicago, Illinois, researchers at the University of Chicago used electronic health records to track adherence to at least 6 weekly doses of PrEP during the first year of HIV infection prophylaxis and compared baseline as well as time-varying patient characteristics.

As a result, the researchers found 3 patterns of PrEP use among the 2159 patients whose records they assessed. The most common pattern, found in 40% of participants, was sustained use. The next most common pattern was short-term use, found in 30% of participants, and the least common was decreasing use, found in 29% of participants.

Using adjusted models, the researchers also found that younger age, Black race, gender, sexual orientation, baseline insurance status, and neighborhood were associated with the pattern of use that a patient had followed. For example, for some use patterns, insurance coverage or lack thereof during follow-up was associated with the chance of monthly adherence to at least 6 weekly doses.

“Access to clinics, insurance, and intersectional stigmas may be modifiable barriers to effective PrEP persistence,” concluded the researchers, adding that a “focus on younger users and beyond gay, cismale populations” is needed.

 

—Ellen Kurek

 

Reference:

Pyra M, Brewer R, Rusie L, Kline J, Willis I, Schneider J. Long-term HIV pre-exposure prophylaxis trajectories among racial & ethnic minority patients: short, declining, & sustained adherence. J Acquir Immune Defic Syndr. 2022;89(2):166-171. doi:10.1097/ QAI.0000000000002833