Open AccessAre We Hitting the Target? HIV Pre-Exposure Prophylaxis from 2012 to 2020 in the OPERA Cohort
Author(s) -
Karam Mounzer,
Jennifer S Fusco,
Ricky Hsu,
Laurence Brunet,
Vani Vannappagari,
Kevin R. Frost,
Mark S. Shaefer,
Alex Rinehart,
Keith Rawlings,
Gregory Fusco
Publication year - 2021
Publication title -
aids patient care and stds
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.504
H-Index - 85
eISSN - 1557-7449
pISSN - 1087-2914
DOI - 10.1089/apc.2021.0064
Subject(s) - medicine , pre exposure prophylaxis , cohort , epidemiology , men who have sex with men , seroconversion , human immunodeficiency virus (hiv) , poisson regression , incidence (geometry) , demography , cohort study , family medicine , population , environmental health , physics , syphilis , sociology , optics
Preventing HIV transmission is a crucial step in ending the HIV epidemic. Safe and effective pre-exposure prophylaxis (PrEP) has been available in the United States since 2012. We set out to determine if persons at greatest risk for HIV acquisition were receiving HIV PrEP. HIV-negative individuals from the Observational Pharmaco-Epidemiology Research & Analysis (OPERA) cohort who were prescribed daily PrEP were contrasted with newly diagnosed HIV persons without PrEP use between July 16, 2012 and October 31, 2020 to determine if the PrEP prescriptions reached the populations who were seroconverting. Poisson regression was used to estimate incidence rates of seroconversion to HIV among PrEP initiators, as well as new diagnoses of sexually transmitted infections among both the PrEP group and the newly HIV+ group. Out of the 14,598 PrEP users and 3558 persons newly diagnosed with HIV in OPERA, demographics varied widely. Older individuals, those of non-Black race, men, nonintravenous (IV) drug users, and those with commercial insurance were proportionally overrepresented among those prescribed PrEP compared to persons newly diagnosed with HIV during the same time period. Over 82% of new HIV+ individuals received care in the southern United States compared to only 45% of PrEP users. Seroconversion to HIV among PrEP users was generally uncommon, although more frequent among those who identified as Black individuals, especially in the 13-25 years old age range. In conclusion, providers need innovative programs to better identify, educate, and link those at greatest risk of HIV acquisition, especially young people, women, Black individuals, and IV drug users, to PrEP.