More than 50% of men who stopped taking PrEP contracted HIV within six months

According to a study, published in JAIDS, men who have sex with men (MSM) who stop taking Pre-Exposure Prophylaxis (PrEP) are likely to be diagnosed with HIV within the following six months.

Data from a study undertaken by the Department of Public Health in Washington State from 2013 to 2021 was used for the analysis. Of the 1,098 MSM adults who were diagnosed with HIV during this period 797 (73%) were interviewed about their experience with PrEP.

Approximately 1 in 4 (25%) of participants who were diagnosed with HIV in 2020/21 reported that they had previously taken PrEP or had used it inconsistently. More than 50% of previous PrEP users were diagnosed within six months of stopping PrEP.

The researchers identified several main reasons for the refusal or discontinuation of PrEP:

• Confidence that the individual has a low risk of HIV infection (13%)
• Side effects (13%)
• Problems with the cost of PrEP and insurance that covers it (13%)
• Homelessness, unstable housing, moving to a new area (10%)

Less common reasons included pill burden, discussing their doctors visits, and difficulties getting an appointment.

The analysis shows that all areas of the health system need to work together to improve PrEP uptake and adherence.

Firstly, it’s important to make sure that information about PrEP is correct and up to date. Patients should be advised about potential side effects and how to mitigate them, and an open dialogue should be maintained between patient and healthcare professionals. Secondly, the burden of follow-up for PrEP patients should be reduced where possible.

"Clinics may need additional innovations to expand opportunities, such as higher availability of telemedicine, online STI testing, home testing for STIs, as well as home PrEP monitoring and care for asymptomatic people," says Dr. Chase Cannon of the University of Washington.

A previous study showed that around 41% of people who start taking PrEP discontinue is within the first six months. Heterosexual men and women were the mostly likely to discontinue PrEP (72%) whilst men who have sex with men and trans women were least likely to stop PrEP (31%).