Evidence map›Paper›PMID 33441446›Full record

ArticleSexually transmitted infections2022

Implementation of a national HIV pre-exposure prophylaxis service is associated with changes in characteristics of people with newly diagnosed HIV: a retrospective cohort study.

Ceilidh Grimshaw, Claudia S Estcourt, Rak Nandwani, Alan Yeung, David Henderson, John Michael Saunders

Open access · hybridAbstract read
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Article in Sexually transmitted infections, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.7field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 16 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 4 countries.

Ceilidh GrimshawSandyford Initiative, NHS Greater Glasgow and Clyde, Glasgow, UK ceilidh.grimshaw@ggc.scot.nhs.uk.ORCID 0000-0002-7139-5797
Claudia S EstcourtSchool of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.ORCID 0000-0001-5523-5630
Rak NandwaniBrownlee Centre for Infectious and Communicable Diseases, NHS Greater Glasgow and Clyde, Glasgow, UK.ORCID 0000-0002-4611-3786
Alan YeungSchool of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.ORCID 0000-0001-5226-3695
David HendersonBlood borne viruses and sexually transmitted infections section, Public Health Scotland, Glasgow, UK.
John Michael SaundersHIV & STI Department, Public Health England, London, UK.ORCID 0000-0001-9658-7798
Glasgow Caledonian University · GBNHS Greater Glasgow and Clyde · GBPublic Health England · GBPublic Health Scotland · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo review characteristics of individuals newly diagnosed with HIV following implementation of a national pre-exposure prophylaxis (PrEP) programme (comprehensive PrEP services, delivered in sexual health clinics) to inform future delivery and broader HIV prevention strategies.

methodsWe extracted data from national HIV databases (July 2015-June 2018). We compared sociodemographic characteristics of individuals diagnosed in the period before and after PrEP implementation, and determined the proportion of 'potentially preventable' infections with the sexual health clinic-based PrEP delivery model used.

resultsThose diagnosed with HIV before PrEP implementation were more likely to be male (342/418, 81.8% vs 142/197, 72.1%, p=0.005), be white indigenous (327/418, 78.2% vs 126/197, 64.0%, p<0.001), report transmission route as sex between men (219/418, 52.4% vs 81/197, 41.1%, p=0.014), and have acquired HIV in the country of the programme (302/418, 72.2% vs 114/197, 57.9% p<0.001) and less likely to report transmission through heterosexual sex (114/418, 27.3% vs 77/197, 39.1%, p=0.002) than after implementation.Pre-implementation, 8.6% (36/418) diagnoses were 'potentially preventable' with the PrEP model used. Post-implementation, this was 6.6% (13/197), but higher among those with recently acquired HIV (49/170, 28.8%). Overall, individuals with 'potentially preventable' infections were more likely to be male (49/49, 100% vs 435/566, 76.9%, p<0.001), aged <40 years (37/49, 75.5% vs 307/566, 54.2%, p=0.004), report transmission route as sex between men (49/49, 100% vs 251/566, 44.3%, p<0.001), have previously received post-exposure prophylaxis (12/49, 24.5% vs 7/566, 1.2%, p<0.001) and less likely to be black African (0/49, 0% vs 67/566, 11.8%, p=0.010) than those not meeting this definition.

conclusionsThe sexual health clinic-based national PrEP delivery model appeared to best suit men who have sex with men and white indigenous individuals but had limited reach into other key vulnerable groups. Enhanced models of delivery and HIV combination prevention are required to widen access to individuals not benefiting from PrEP at present.

Indexed as

AdultDatabases, FactualFemaleHealth Plan ImplementationHIV InfectionsHomosexuality, MaleHumansMaleMiddle AgedPre-Exposure ProphylaxisRetrospective StudiesSexual PartnersYoung AdultHIVHIV pre-exposure prophylaxisPrEPservice delivery

Identifiers

PMID33441446
PMCPMC8785015
OpenAlexW3120313172

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.