Trajectories of Pre-Exposure Prophylaxis (PrEP) Adherence Among Commercially Insured Individuals

Ikenna Unigwe; Amie Goodin; Wei-Hsuan Lo-Ciganic; Robert L Cook; Haesuk Park

doi:10.1093/cid/ciad756

Trajectories of Pre-Exposure Prophylaxis (PrEP) Adherence Among Commercially Insured Individuals

Clin Infect Dis. 2023 Dec 8:ciad756. doi: 10.1093/cid/ciad756. Online ahead of print.

Authors

Ikenna Unigwe¹, Amie Goodin¹, Wei-Hsuan Lo-Ciganic^{2

3

4}, Robert L Cook⁵, Haesuk Park¹

Affiliations

¹ Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, Florida, USA.
² Division of General Internal Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
³ Center for Pharmaceutical Policy and Prescribing, Health Policy Institute, University of Pittsburgh, Pennsylvania, USA.
⁴ North Florida/South Georgia Veterans Health System; Geriatric Research Education and Clinical Center, Gainesville, Florida, USA.
⁵ Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, Florida, USA.

PMID: 38066587
DOI: 10.1093/cid/ciad756

Abstract

We used group-based trajectory models to identify four distinct trajectory patterns of adherence to pre-exposure prophylaxis (PrEP) among 20,696 users. Only 44.5% were consistently PrEP adherent, with younger age, being female, or having substance use disorder or depression associated with early discontinuation. Public health efforts are needed to improve PrEP adherence.

Keywords: Adherence; MarketScan; PrEP; group-based trajectory modeling; pre-exposure prophylaxis.