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Non-adherence, discontinuation, and seroconversion among people on daily HIV pre-exposure prophylaxis (PrEP) in Brazil: a nationwide cohort study.

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Title: Non-adherence, discontinuation, and seroconversion among people on daily HIV pre-exposure prophylaxis (PrEP) in Brazil: a nationwide cohort study.
Authors: Crepalde-Ribeiro, Kennedy, Braga, Maria das Graças, Silveira, Micheline Rosa, Moura, Alexandre Sampaio, Vaz-de-Melo, Pedro O.S., Ferraz, Matheus Marchesotti Dutra, Pearson, Sallie-Anne, Costa, Juliana de Oliveira
Source: AIDS Care. Feb2025, Vol. 37 Issue 2, p289-299. 11p.
Subjects: HIV prevention, Patient compliance, Risk assessment, HIV seroconversion, Research funding, Logistic regression analysis, Sex distribution, Seroconversion, Descriptive statistics, HIV infections, Population geography, Pre-exposure prophylaxis, Drugs, Patient refusal of treatment, Confidence intervals, Educational attainment
Geographic Terms: Brazil
Abstract: The goal of this study was to evaluate characteristics associated with Pre-exposure Prophylaxis for HIV infection (PrEP) non-adherence or discontinuation in Brazil and assess the association between these outcomes and HIV seroconversion. We used linked national dispensing and pathology data to identify people aged 14+ years initiating PrEP in 2018. We estimated non-adherence using the proportion of days covered (PDC), defining non-adherence as PDC < 60%. We defined discontinuation as a gap in therapy of at least 120 days. We used logistic regression models to assess characteristics associated with non-adherence or discontinuation within 365 days and to assess HIV seroconversion and its association with non-adherence or discontinuation. In 2018, 5100 people initiated PrEP; 34.4% (95%CI 33.1%; 35.7%) were non-adherent and 34.3% (95%CI 33.0%; 35.6%) discontinued. People aged 34 years or less, women, people with lower education levels, or living in the Northern region of Brazil were more likely to be non-adherent or discontinue therapy. Thirty people (0.6% 95%CI 0.4%; 0.8%) seroconverted. HIV seroconversion was associated with PrEP non-adherence or discontinuation (OR = 6.2 for both). Non-adherence and discontinuation were common in people initiating PrEP and strongly associated with HIV seroconversion. Our work identifies populations at higher risk of non-adherence or discontinuation which could be targeted in interventions to reduce new HIV cases in Brazil. [ABSTRACT FROM AUTHOR]
Copyright of AIDS Care is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Non-adherence, discontinuation, and seroconversion among people on daily HIV pre-exposure prophylaxis (PrEP) in Brazil: a nationwide cohort study.
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22AIDS+Care%22&quot;&gt;AIDS Care&lt;/searchLink&gt;. Feb2025, Vol. 37 Issue 2, p289-299. 11p.
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  Data: The goal of this study was to evaluate characteristics associated with Pre-exposure Prophylaxis for HIV infection (PrEP) non-adherence or discontinuation in Brazil and assess the association between these outcomes and HIV seroconversion. We used linked national dispensing and pathology data to identify people aged 14+ years initiating PrEP in 2018. We estimated non-adherence using the proportion of days covered (PDC), defining non-adherence as PDC &lt; 60%. We defined discontinuation as a gap in therapy of at least 120 days. We used logistic regression models to assess characteristics associated with non-adherence or discontinuation within 365 days and to assess HIV seroconversion and its association with non-adherence or discontinuation. In 2018, 5100 people initiated PrEP; 34.4% (95%CI 33.1%; 35.7%) were non-adherent and 34.3% (95%CI 33.0%; 35.6%) discontinued. People aged 34 years or less, women, people with lower education levels, or living in the Northern region of Brazil were more likely to be non-adherent or discontinue therapy. Thirty people (0.6% 95%CI 0.4%; 0.8%) seroconverted. HIV seroconversion was associated with PrEP non-adherence or discontinuation (OR = 6.2 for both). Non-adherence and discontinuation were common in people initiating PrEP and strongly associated with HIV seroconversion. Our work identifies populations at higher risk of non-adherence or discontinuation which could be targeted in interventions to reduce new HIV cases in Brazil. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of AIDS Care is the property of Taylor &amp; Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=182326803
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1080/09540121.2024.2443824
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 11
        StartPage: 289
    Subjects:
      – SubjectFull: HIV prevention
        Type: general
      – SubjectFull: Patient compliance
        Type: general
      – SubjectFull: Risk assessment
        Type: general
      – SubjectFull: HIV seroconversion
        Type: general
      – SubjectFull: Research funding
        Type: general
      – SubjectFull: Logistic regression analysis
        Type: general
      – SubjectFull: Sex distribution
        Type: general
      – SubjectFull: Seroconversion
        Type: general
      – SubjectFull: Descriptive statistics
        Type: general
      – SubjectFull: HIV infections
        Type: general
      – SubjectFull: Population geography
        Type: general
      – SubjectFull: Pre-exposure prophylaxis
        Type: general
      – SubjectFull: Drugs
        Type: general
      – SubjectFull: Patient refusal of treatment
        Type: general
      – SubjectFull: Confidence intervals
        Type: general
      – SubjectFull: Educational attainment
        Type: general
      – SubjectFull: Brazil
        Type: general
    Titles:
      – TitleFull: Non-adherence, discontinuation, and seroconversion among people on daily HIV pre-exposure prophylaxis (PrEP) in Brazil: a nationwide cohort study.
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            – D: 01
              M: 02
              Text: Feb2025
              Type: published
              Y: 2025
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