Lower PrEP Retention among Young and Black Clients Accessing PrEP at a Cluster of Safety Net Clinics for Gay and Bisexual Men

J Int Assoc Provid AIDS Care. 2024 Jan-Dec:23:23259582241275857. doi: 10.1177/23259582241275857.

Abstract

Young men of color who have sex with men are vulnerable to HIV and experience poor PrEP uptake and retention. We conducted a secondary data analysis and calculated adjusted Prevalence Odds Ratios (aPORs) for PrEP retention along with 95% CIs at 90, 180, and 360 days at an organization running safety net clinics in Texas for gay and bisexual men. We found statistically significant association with age, race, in-clinic versus telehealth appointments, and having healthcare insurance. White clients had an aPOR of 1.29 [1.00, 1.67] as compared to Black clients at 90 days. Age group of 18-24 had a lower aPOR than all other age groups except 55 or older at all three time periods. Clients who met providers in person had an aPOR of 2.6 [2.14, 3.19] at 90, 2.6 [2.2, 3.30] at 180 days and 2.84 [2.27, 3.54] at 360 days. Our findings highlight the need for population-specific targeted interventions.

Keywords: HIV/AIDS; PrEP (pre-exposure prophylaxis) < innovations in treatment and prevention; case management < health services in HIV/AIDS care; healthcare infrastructure < country profiles (how nations address the AIDS epidemic); prevention programs < country profiles (how nations address the AIDS epidemic); retention in care < health services in HIV/AIDS care.

Plain language summary

Lower PrEP retention for black and young MSM in TexasOur study findings suggest that of all clients who start PrEP, Black clients and younger clients had a higher chance of not continuing PrEP as compared to White clients and older clients respectively. This analysis was done for a clinic that pre-dominantly offers services to gay and bisexual men. We also found that those who were attending clinic in person had higher chances of continuing. Further those who are insured also had higher chances of continuing.

MeSH terms

  • Adolescent
  • Adult
  • Anti-HIV Agents* / therapeutic use
  • Bisexuality
  • Black or African American*
  • HIV Infections* / prevention & control
  • Homosexuality, Male
  • Humans
  • Male
  • Middle Aged
  • Pre-Exposure Prophylaxis* / statistics & numerical data
  • Safety-net Providers* / statistics & numerical data
  • Sexual and Gender Minorities*
  • Texas
  • White
  • Young Adult

Substances

  • Anti-HIV Agents