ArticleAIDS (London, England)2020
A taxonomy of pragmatic measures of HIV preexposure prophylaxis use.
Article in AIDS (London, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Performance of Adherence Measures for Oral, Tenofovir-Based HIV Pre-Exposure Prophylaxis: A Systematic Review.AIDS and behavior · 2025Pooled it
- Risk-based versus universal PrEP delivery during pregnancy: a cluster randomized trial in Western Kenya from 2018 to 2019.Journal of the International AIDS Society · 2023Trial
- A Pilot Study of a Patient Navigation Intervention to Improve HIV Pre-exposure Prophylaxis Persistence Among Black/African American Men Who Have Sex With Men.Journal of acquired immune deficiency syndromes (1999) · 2022Trial
- Establish a PrEP (Pre-Exposure Prophylaxis) Epidemiology, Modeling, and Surveillance (PREMISE) System to Analyze Trends in PrEP Uptake and the Impact of PrEP Programs and Policies: Protocol for a Natural Experiment and Modeling Study in the United States.JMIR research protocols · 2026Article
- Alcohol Use Disorder Diagnoses and HIV Preexposure Prophylaxis Adherence and Continuation: a Retrospective Cohort Study.Journal of general internal medicine · 2026Article
- Authors' response: Addressing the blind spot of self-reported adherence in the era of long-acting PrEP.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2026Article
- Doxycycline Postexposure Prophylaxis and Bacterial Sexually Transmitted Infections Among Individuals Using HIV Preexposure Prophylaxis.JAMA internal medicine · 2025Article
- HIV Prevention and Care Among Black Cisgender Sexual Minority Men and Transgender Women: Protocol for an HIV Status-Neutral Cohort Study Using an Observational-Implementation Hybrid Approach.JMIR research protocols · 2023Article
- HIV preexposure prophylaxis treatment patterns in a national health plan population.Journal of managed care & specialty pharmacy · 2023Article
- PrEP Persistence Support and Monitoring in Areas of High HIV Burden in the Midwestern United States.AIDS education and prevention : official publication of the International Society for AIDS Education · 2023Article
- PrEP Use and Adherence among Transgender Persons in Chicago, IL (SHIPP Study, 2014-2018, USA).AIDS and behavior · 2023Article
- HIV Pre-exposure Prophylaxis Use and Persistence among Black Ciswomen: "Women Need to Protect Themselves, Period".Journal of racial and ethnic health disparities · 2022Article
- Long-term HIV Pre-exposure Prophylaxis Trajectories Among Racial & Ethnic Minority Patients: Short, Declining, & Sustained Adherence.Journal of acquired immune deficiency syndromes (1999) · 2022Article
- "PrEP's just to secure you like insurance": a qualitative study on HIV pre-exposure prophylaxis (PrEP) adherence and retention among black cisgender women in Mississippi.BMC infectious diseases · 2021Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
objectivesAs delivery of preexposure prophylaxis (PrEP) becomes an HIV prevention priority in the United States, standard, pragmatic measures of PrEP use are needed to compare and evaluate prevention implementation programs. By using readily available electronic health record data, we describe and compare measures of persistence and retention.
designRetrospective cohort.
methodsUsing electronic health record prescription data for patients at a large urban Federally Qualified Health Center from 2015 to 2019, we calculated measures of persistence and retention and compared them to pharmacy claims data, PrEP biomarkers, and HIV outcomes.
resultsTotal PrEP time was 19.8 months on average. During this period, average adherence by medication prescription ratio (MRxR) was 89%; 77% of patients had an MRxR at least 85% and 90% have an MRxR at least 57%. Over the first 6 months, average proportion of days covered (PDC) at least 85% was 53% and PDC at least 57% was 57%. Prescription fill rates, based on claims data from a pharmacy partner, ranged from 45 to 60%. Using tenofovir-diphosphate as the gold standard, PDC had high sensitivity (97%) but low specificity (≤13%). As a measure of retention, over the first 6 months, 59% of patients had quarterly HIV tests.
conclusionTotal PrEP time is useful measure of overall persistence, while PDC can assess persistence and adherence at a specific time point. Adherence by PDC is more conservative compared with MRxR; both will overestimate true adherence. Retention in care can be measured by quarterly HIV tests. Using consistent terminology and reporting timepoints and adherence thresholds will help reporting and comparing PrEP delivery programs.
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