Only 40% of Americans do not quit PrEP for two years

According to Walgreens, the largest pharmacy network in the United States, only two out of five people continue to receive pre-exposure prophylaxis for HIV (PrEP) two years after the start. The analysis was published this week in the AIDS Society.

According to experts, the majority of PrEP adherence research has so far dealt with shorter periods of time and believed that if participants did not abandon Truvada during the PrEP start period, they are more likely to stick to prevention. New research does not confirm this.

Scientists analyzed pharmacy records about the issuance of medicines for a random sample of 7148 people who first applied for PrEP to the Walgreens branch in 2015.

Next, experts collected data for two years after the start of prophylaxis. PrEP's commitment was determined by them to be no less than 16 days of taking Truvada for at least three-quarters of months (for example, nine months a year).

The 16-day threshold was chosen because scientists had previously found that ART dosage at least four days a week can provide the necessary protection against HIV.

The overwhelming majority of PrEP users were male (97%). Most of them were over thirty or about forty, and 80% had commercial insurance.

During the first 12 months, 56% of participants (4030/7148) were identified by experts as PrEP “permanent” users.

Among those who were committed to therapy during the first year, 63% (2521/4030) took the drug from 13 to 24 months.

During the first 24 months, 41% of the participants (2951/7148) remained committed (that is, they had prescriptions for at least 18 out of 24 months).

People have what are called “risk seasons,” the researchers commented on the results, so many of those who use PrEP do not retain their absolute commitment for the full two years.

However, according to the authors, this is not the only factor that explains the discontinuation of medication use by such a large number of people.

"A significant change in the behavior of 60% of those starting PrEP is extremely unlikely."

When analyzing the data, experts found that the average age of the participants was over 25 years old, and most of them had commercial insurance and an extra $ 20 dollars or less for the purchase of PrEP. These people, as was shown above, for 2 years almost did not change their attitude towards the OST.

However, at the same time, only 29% of people aged 18 to 25 years remained committed to prevention after 2 years. Experts attribute this to the unstable socio-economic situation of this population group.

"Young people may be more likely to face various kinds of problems, including financial and social, for example, associated with the fear of disclosing information due to the use of parental insurance," the authors explained.