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Publication Profiles

Factors associated with suboptimal retention in HIV pre-exposure prophylaxis care among men who have sex with men

Citation

Rogers BG, Sosnowy C, Chan PA, et al. Factors associated with suboptimal retention in HIV pre-exposure prophylaxis care among men who have sex with men. AIDS Care. 2023;35(4):495-508. doi:10.1080/09540121.2022.2129036

Implementation stage:

Sustainment

Implementation outcomes reported:

Not applicable

Continuum target addressed:

PrEP persistence

Geography:

Non-priority jurisdiction

Study Participant Classification:

Recipients of care

Plain Language Objectives

The researchers wanted to understand why men who have sex with men sometimes stopped or fell out of HIV-prevention care. They interviewed patients with a lapse in use across three U.S. regions and asked how services could improve.

Plain Language Abstract

Pre-exposure prophylaxis, or PrEP, prevents HIV when used as directed, but many patients do not remain in care. Researchers conducted semi-structured interviews with 49 men who have sex with men from clinics in the Midwest, South, and Northeast. Every participant had previously received PrEP care and experienced a lapse in use. Participants described structural barriers such as transportation difficulties and out-of-pocket costs; social barriers including misinformation from media and personal networks; clinical barriers such as inconvenient appointment timing and frequency; and behavioral factors including changes in sexual activity or believing their HIV risk was low. They suggested reducing medication and laboratory costs, offering flexible appointments, providing culturally responsive services, and strengthening patient navigation. The findings show how practical, social, and clinical conditions can interact when patients decide whether to continue PrEP care. They can help clinics identify service changes for testing, but the study did not evaluate whether the suggested changes improve retention. Because this was a qualitative study of patients who had already experienced a lapse, the themes reflect their experiences and are not estimates for all PrEP users.

Key Takeaways

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