SynthesisThe lancet. HIV2022
Discontinuation, suboptimal adherence, and reinitiation of oral HIV pre-exposure prophylaxis: a global systematic review and meta-analysis.
Synthesis in The lancet. HIV, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06133686 (Implementing Oral), which is not on this map. Cited by 142 papers, 4 of them syntheses that pooled 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.
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.
Implementing Oral (Event-driven and Daily) and Long-acting Pre-Exposure Prophylaxis in Mobile Men in Sub-Saharan Africa: a Phase 3b, Open-label, Hybrid Type 2 Implementation and Effectiveness Trial
Who cites it
142 citing papers in PubMed, 4 syntheses or guidelines pooled it, 204 citations in OpenAlex.
- Interest in and Preference for Long-Acting Injectable Pre-exposure Prophylaxis Among Men Who Have Sex With Men, Trans* Individuals, and Cisgender Heterosexual Women: A Global Systematic Review and Meta-Analysis.Journal of acquired immune deficiency syndromes (1999) · 2025Pooled it
- Performance of Adherence Measures for Oral, Tenofovir-Based HIV Pre-Exposure Prophylaxis: A Systematic Review.AIDS and behavior · 2025Pooled it
- Impact of mHealth on enhancing pre-exposure prophylaxis adherence and strengthening the HIV prevention cascade among key populations: a systematic review and meta-analysis.Frontiers in public health · 2025Pooled it
- Oral pre-exposure prophylaxis retention among men who have sex with men and transgender persons: Systematic review and meta-analysis.PloS one · 2025Pooled it
- PrEP and Contraceptive Persistence Among Young Women Receiving Sexual and Reproductive Health Services Through Hair Salons in South Africa.Journal of acquired immune deficiency syndromes (1999) · 2026Trial
- Trial
- Leveraging infant visit PrEP screening INtegration & tasK shifting to improve post-partum HIV prevention in Malawi (LINK): a cluster-randomized trial evaluation of a postpartum HIV prevention package among breastfeeding women in Malawi.BMC health services research · 2025Trial
- The effect of a social network-based intervention to promote HIV testing and linkage to HIV services among fishermen in Kenya: a cluster-randomised trial.The Lancet. Global health · 2025Trial
- Impact of a point-of-care urine tenofovir assay on adherence to HIV pre-exposure prophylaxis among women in Kenya: a randomised pilot trial.The lancet. HIV · 2024Trial
- Oral Preexposure Prophylaxis Uptake and Discontinuation in the HIV Vaccine Trials Network 704/HIV Prevention Trials Network 085 Study: Implications for Biomedical Human Immunodeficiency Virus Prevention Trials.Open forum infectious diseases · 2024Trial
- A decision support tool has similar high PrEP uptake and increases early PrEP persistence in adolescent girls and young women in South Africa: results from a randomized controlled trial.Journal of the International AIDS Society · 2023Trial
- A Pay-It-Forward Approach to Improve Chlamydia and Gonorrhea Testing Uptake Among Female Sex Workers in China: Venue-Based Superiority Cluster Randomized Controlled Trial.JMIR public health and surveillance · 2023Trial
- Trial
- PrEP reinitiation, uptake, and persistence as targets for reducing HIV incidence and racial and ethnic inequities among men who have sex with men in Boston, USA: a network modeling study.Lancet regional health. Americas · 2026Article
- Eligibility and Acceptability of Same-Day HIV Preexposure Prophylaxis Initiation During Emergency Care Encounters in Nairobi, Kenya: A Cross-Sectional Study.Journal of acquired immune deficiency syndromes (1999) · 2026Article
- Review
- Long-acting HIV pre-exposure prophylaxis adherence and discontinuation: a global systematic review and meta-analysis.EClinicalMedicine · 2026Article
- Prior PrEP use and discontinuation in individuals newly diagnosed with HIV.HIV medicine · 2026Article
- Life-steps for PrEP nurse-delivered adherence intervention: Protocol for a multisite randomized clinical trial.Contemporary clinical trials · 2026Article
- Determinants of PrEP Delivery Platform Choice in Adolescents and Young People: The Fast-PrEP Project in Cape Town, South Africa.International journal of environmental research and public health · 2026Article
82 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
13 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundPoor adherence to oral HIV pre-exposure prophylaxis (PrEP) diminishes its clinical and public health benefits. This study synthesises evidence regarding discontinuation, adherence, and reinitiation of PrEP among geographically diverse PrEP users.
methodsWe did a systematic review and meta-analysis evaluating studies published in MEDLINE, Embase, and Cochrane Central Register of Controlled Trials from inception to Dec 18, 2020. We included longitudinal studies that presented data for PrEP discontinuation, defined as investigator-reported loss to follow-up or participant self-reported PrEP stoppage. Data were extracted from published reports and assessed for risk of bias. We used a random-effects meta-analysis to pool estimates of discontinuation and I
findingsWe identified 4129 records, of which 59 articles were included (n=43 917 participants). 41·0% (95% CI 18·8-63·5) of participants discontinued PrEP within 6 months, with the highest rates in observational studies. The discontinuation rate in sub-Saharan Africa (47·5%, 95% CI: 29·4-66·4%) was higher than in other regions (p<0·001). Discontinuation rates were lower in studies with adherence interventions than in those without (24·7% vs 36·7%, p=0·015). Gay or bisexual men who have sex with men and transgender women offered daily or non-daily dosing options had lower discontinuation rates than those offered daily dosing alone (21·6% vs 31·5%; p<0·001). The pooled suboptimal adherence within 6 months was 37·7% (95% CI 8·4-66·9). Among people who discontinued PrEP, 47·3% (95% CI 31·5-63·2) reinitiated PrEP within 1 year of PrEP initiation. The included studies had poor quality in terms of study design, with a moderate risk of bias.
interpretationStrategies to encourage reinitiating PrEP for new or persistent risk should be a focus of future PrEP implementation strategies.
fundingNational Institutes of Health and Nature Science Foundation of China.
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What OpenQuestion holds
Registered trials
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.