ArticleJournal of the International AIDS Society2023
Discontinuation of government subsidized HIV pre-exposure prophylaxis in Australia: a whole-of-population analysis of dispensing records.
Article in Journal of the International AIDS Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 16 citations in OpenAlex.
- Use of HIV Phylogenetic Analysis in Public Health in Victoria, Australia: Regulatory Considerations.Journal of bioethical inquiry · 2026Article
- Article
- Estimating Prevention-Effective Adherence to HIV Pre-exposure Prophylaxis (PrEP) Among Australian Gay, Bisexual and Queer Men and Non-binary People: A Mixed-Methods Analysis.AIDS and behavior · 2026Article
- Discontinuation of Pre-exposure Prophylaxis in Men Who Have Sex with Men in Taiwan: A Prospective Study of Event-Driven Regimens.AIDS and behavior · 2026Article
- "I Stopped to Prove them Wrong:" Reasons for Discontinuing Daily Oral HIV Pre-exposure Prophylaxis Among Women at High Risk of HIV in Tanzania-A Convergent Mixed Methods Study.AIDS and behavior · 2026Article
- A Competing Risks Duration Model to Study PrEP Discontinuation Among MSM in France: The ERAS 2023 Study.AIDS and behavior · 2025Article
- Subpopulations with frequent healthcare barriers have increased risk of sexually transmitted infections and dropping out from HIV preexposure prophylaxis care.AIDS (London, England) · 2025Article
- Engagement in Preexposure Prophylaxis Care at 1 Year Among Men Who Have Sex With Men Enrolled in the French ANRS PREVENIR Cohort Study.Open forum infectious diseases · 2025Article
- Ending HIV Transmission in Australia: Expanding PrEP to Cisgender Women: A Scoping Review.AIDS and behavior · 2024Article
- Pre-exposure prophylaxis (PrEP) use trajectories and incidence of HIV and other sexually transmitted infections among PrEP users in Belgium: a cohort analysis of insurance claims data from 2017 to 2019.BMC public health · 2024Article
- HIV Pre-exposure Prophylaxis (PrEP) Care in Belgium: A mixed-methods Study on PrEP Users' Experiences and Service Delivery Preferences.AIDS and behavior · 2024Article
- Willingness to pay and price elasticity of demand for long-acting injectable cabotegravir among men who have sex with men in Guangxi, China.Frontiers in pharmacology · 2024Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionHIV pre-exposure prophylaxis (PrEP) has been government subsidized in Australia since April 2018 and while uptake is high among men who have sex with men, rates of discontinuation are also high. The aims of this study were to examine the impact of discontinuation on overall PrEP usage, the proportion of PrEP users who discontinue and the predictors of discontinuation.
methodsWe used linked de-identified dispensing records of all government subsidized PrEP in Australia between April 2018 and September 2021: a whole-of-population data set. Defining discontinuation as 180 days or more without PrEP after the final dispensed supply, we calculated the number of people who discontinued at each 6-month interval during the study period, the proportion who had discontinued 2 years after the first supply and, using Cox regression, predictors of discontinuation.
resultsOf 49,164 people dispensed PrEP (98.5% male, median age 34 years), 40.3% (19,815) had discontinued by September 2021. Within 2 years of their first supply, 11,150 (37.7%) of 29,549 PrEP users had discontinued, including 10.0% after a single dispensed supply. Large variations were observed, particularly according to prescriber characteristics: discontinuation was higher among people prescribed PrEP by low caseload (≤10 patients) prescribers (61.2%) than by high caseload (>100 patients) prescribers (31.1%, p<0.001), and by prescribers practising in areas with low estimated prevalence (<1.0%) of gay men (64.1%) than high (>5%) prevalence (36.7%, p<0.001). Women and younger people were more likely to discontinue, while patients receiving a higher level of government subsidy were less likely. The independent predictors of discontinuation with the greatest effect size were female sex (adjusted hazards ratio [aHR] 2.99, p<0.001), low estimated gay prevalence of prescriber location (aHR 1.98, p<0.001) and low prescriber PrEP caseload (aHR 1.79, p<0.001).
conclusionsThere are high rates of PrEP discontinuation in Australia and some populations are at increased risk of discontinuation. Strategies are needed to support persistence on PrEP and the re-starting of PrEP during periods of risk.
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