Evidence map›Paper›PMID 36586011›Full record

ArticleAIDS and behavior2023

Measuring Oral Pre-exposure Prophylaxis (PrEP) Continuation Through Electronic Health Records During Program Scale-Up Among the General Population in Zambia.

Elizabeth Heilmann, Jackson Okuku, Megumi Itoh, Jonas Z Hines, Jose Tomas Prieto, Mutinta Phiri, Kelvin Watala, Chilufya Nsofu, Melinda Luhana-Phiri, Natalie Vlahakis and 4 more

Abstract read
In one paragraph

Article in AIDS and behavior, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. 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

14 authors.

Elizabeth HeilmannPHI/CDC Global Health Fellowship Program, Public Health Institute, Oakland, CA, USA. qng0@cdc.gov.ORCID http://orcid.org/0000-0002-8328-9975
Jackson OkukuDivision of Global HIV & TB, Centers for Disease Control and Prevention, 351 Independence Avenue, Lusaka, Zambia.ORCID http://orcid.org/0000-0002-2283-8993
Megumi ItohDivision of Global HIV & TB, Centers for Disease Control and Prevention, 351 Independence Avenue, Lusaka, Zambia.ORCID http://orcid.org/0000-0003-3736-6287
Jonas Z HinesDivision of Global HIV & TB, Centers for Disease Control and Prevention, 351 Independence Avenue, Lusaka, Zambia.ORCID http://orcid.org/0000-0002-4877-0333
Jose Tomas PrietoPalantir Technologies, Paris, France.
Mutinta PhiriLusaka Provincial Health Office, Ministry of Health, Lusaka, Zambia.
Kelvin WatalaSouthern Provincial Health Office, Ministry of Health, Choma, Zambia.
Chilufya NsofuWestern Provincial Health Office, Ministry of Health, Mongu, Zambia.
Melinda Luhana-PhiriEastern Provincial Health Office, Ministry of Health, Chipata, Zambia.
Natalie VlahakisCentre for Infectious Disease Research in Zambia, Lusaka, Zambia.
Michael KabongoCentre for Infectious Disease Research in Zambia, Lusaka, Zambia.
Boyd KalikiDivision of Global HIV & TB, Centers for Disease Control and Prevention, 351 Independence Avenue, Lusaka, Zambia.ORCID http://orcid.org/0000-0002-9432-3577
Peter A MinchellaDivision of Global HIV & TB, Centers for Disease Control and Prevention, 351 Independence Avenue, Lusaka, Zambia.ORCID http://orcid.org/0000-0002-6295-0998
Bupe MusondaMinistry of Health, Lusaka, Zambia.

Funding

CDC HHS 5 NU2GGH002093-05-00Intramural CDC HHS CC999999
6 · The paper itself

Abstract

HIV pre-exposure prophylaxis (PrEP) is being scaled-up in Zambia, but PrEP continuation data are limited by paper-based registers and aggregate reports. Utilization of Zambia's electronic health record (EHR) system, SmartCare, may address this gap. We analyzed individuals aged ≥ 15 years who initiated PrEP between October 2020 and September 2021 in four provinces in Zambia in SmartCare versus aggregate reports. We measured PrEP continuation using Kaplan-Meier survival analysis and Cox proportional hazards models. SmartCare captured 29% (16,791/58,010) of new PrEP clients; 49% of clients continued at one month, and 89% discontinued PrEP by February 2022. Women were less likely than men to discontinue PrEP (adjusted hazard ratio [aHR]: 0.89, 95% CI 0.86-0.92, z = - 6.99, p < 0.001), and PrEP clients aged ≥ 50 years were less likely to discontinue PrEP compared to clients 15-19 years (aHR: 0.53, 95% CI 0.48-0.58, z = - 13.04, p < 0.001). Zambia's EHR is a valuable resource for measuring individual-level PrEP continuation over time and can be used to inform HIV prevention programs.

Indexed as

Anti-HIV AgentsHIV InfectionsPre-Exposure ProphylaxisElectronic Health RecordsFemaleHumansMaleZambiaAnti-HIV AgentsAfricaHIV preventionOral pre-exposure prophylaxisPrEP

Identifiers

PMID36586011
PMCPMC11345677

What OpenQuestion holds

Textmetadata
LicenceTDM
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.