Why I Quit Pre-Exposure Prophylaxis (PrEP)? A Mixed-Method Study Exploring Reasons for PrEP Discontinuation and Potential Re-initiation Among Gay and Bisexual Men
Top Cited Papers
- 5 February 2018
- journal article
- research article
- Published by Springer Science and Business Media LLC in AIDS and Behavior
- Vol. 22 (11), 3566-3575
- https://doi.org/10.1007/s10461-018-2045-1
Abstract
Literature concerning pre-exposure prophylaxis (PrEP) among gay and bisexual identifying men (GBM) has explored facilitators and barriers to uptake and adherence. Far less reported are the reasons why GBM discontinue PrEP use. A national sample of 1071 GBM completed surveys about PrEP use and discontinuation. Participants who were still taking PrEP the 24-month follow up were compared to those that had stopped. Eighteen percent (n = 31) of GBM who reported ever using PrEP discontinued use. Younger (AOR = 0.96; 95% CI 0.92–1.00), and unemployed (AOR = 4.58; 95% CI 1.43–14.70) GBM were more likely to discontinue PrEP than their counterparts. Those that discontinued provided details on why via a free response question. The most common reasons for discontinuation were lower perceived HIV risk (50%) and cost/insurance (30%). Reasons for potential re-initiation included higher-risk sexual activities and changes to structural related barriers. More research is needed to inform interventions on how GBM can continue taking PrEP during changes to employment that effect insurance coverage and cost. La literatura sobre la Profilaxis Pre-Exposición (PrEP) entre hombres que se auto identifican como gay y bisexuales (HGB) ha explorado facilitadores y barreras al uso y la adherencia a la PrEP. Mucho menos reportadas son las razones por las cuales HGB discontinúan el uso de la PrEP. Una muestra nacional de 1071 HGB completó encuestas sobre el uso y la discontinuación de la PrEP. Participantes que todavía estaban tomando PrEP durante su seguimiento a los 24 meses fueron comparados con aquellos que habían dejado de usarla. HGB más jóvenes (AOR = 0.96; 95% C.I. = 0.92-1.00) y desempleados (AOR = 4.58; 95% C.I. = 1.43-14.70) tuvieron una probabilidad más alta de discontinuar la PrEP que sus homólogos. Aquellos que la discontinuaron proveyeron detalles sobre el por qué a través de un cuestionario de repuesta libre. Las razones más comúnmente citada para la discontinuación fueron: bajo riesgo percibido de contraer VIH (50%) y costo/seguro de salud (30%). Razones para potencialmente reiniciarla incluyeron actividades sexuales de más alto riesgo y cambios en las barreras estructurales relacionadas. Mas investigación es necesaria para informar intervenciones sobre cómo los HGB pueden continuar tomando PrEP durante periodos de cambio en el empleo que afectan la cobertura de salud y su costo.Keywords
Funding Information
- National Institute on Drug Abuse (R01-DA036466)
- National Institute on Drug Abuse (K01-DA039030)
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