Evidence map›Paper›PMID 35169002›Full record

ArticleSexually transmitted infections2022

Complex PrEP: the factors requiring consultant-led review of PrEP users.

Victoria Tittle, Rebecca Dalton, Diarmuid Nugent, Nicolo Girometti, Gary Whitlock, Alan Mcowan, Sheena McCormack, Dean Street Collaborative Group

Open access · hybridAbstract read
In one paragraph

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
1.1field-weighted citation impact, top 22% 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, 13 citations in OpenAlex.

  1. Review
  2. Article
  3. Retrospective audit of a convenience cohort of individuals on HIV pre-exposure prophylaxis in Alberta, Canada.Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada · 2022
    Article
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

8 authors at 1 institution in 2 countries.

Victoria Tittle56 Dean Street, HIV, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK victoria.tittle@nhs.net.ORCID 0000-0002-1345-4613
Rebecca Dalton56 Dean Street, HIV, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.
Diarmuid Nugent56 Dean Street, HIV, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.
Nicolo Girometti56 Dean Street, HIV, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.
Gary Whitlock56 Dean Street, HIV, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.
Alan Mcowan56 Dean Street, HIV, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.
Sheena McCormack56 Dean Street, HIV, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.ORCID 0000-0002-7829-1325
Dean Street Collaborative Group
Chelsea and Westminster Hospital NHS Foundation Trust · GB

Funding

Medical Research Council MC_UU_00004/03
6 · The paper itself

Abstract

introductionHIV-1 pre-exposure prophylaxis (PrEP) has been available in England since March 2020 on the National Health Service using generic emtricitabine and tenofovir disoproxil. 56 Dean Street (56DS) provided PrEP through (1) additional private care from September 2015, estimated to be providing 11% of England's PrEP in 2019; and (2) the IMPACT trial, as well as monitoring those self-sourcing PrEP. Providing PrEP at scale through a nurse-led service required a safety net for complex individuals. 56DS introduced a consultant-led PrEP outpatient service, the PrEP review clinic, in January 2018 and we report the outcomes of this service.

methodsWe present a retrospective case note review of the PrEP review clinic with descriptive outcomes from 26 January 2018 to 20 December 2019. Reason for referral, demographics, PrEP management and PrEP discontinuations were recorded.

results13 980 unique users accessed PrEP from 56DS during the two year evaluation period. 220 individuals were seen in the PrEP review clinic. Majority of patients were referred for renal issues (114 of 220, 51.8%), followed by side effects (59 of 220, 26.8%) and comorbidities (38 of 220, 17.2%). Of those with renal issues, 89 (out of 114, 78.1%) users were referred for an abnormal estimated glomerular filtration rate (eGFR). 35 (out of 114, 30.7%) PrEP users had an eGFR between 45 and 59 mL/min/1.73 m DISCUSSION: A small proportion of PrEP users have complex PrEP issues. Methods to manage renal dysfunction with PrEP included stopping supplements and switching to event-based dosing. Those with side effects were managed with an array of options, with only modest effectiveness. Other PrEP options are needed to support those with toxicities or intolerances.

Indexed as

Anti-HIV AgentsHIV InfectionsPre-Exposure ProphylaxisConsultantsHumansRetrospective StudiesState MedicineAnti-HIV Agentshealth services researchpre-exposure prophylaxissexual health

Identifiers

PMID35169002
PMCPMC9685731
OpenAlexW4212942557

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.