Evidence map›Paper›PMID 40222706›Full record

ArticleJournal of substance use and addiction treatment2025

Oral pre-exposure prophylaxis (PrEP) receipt and persistence among opioid-dependent people who inject drugs initiating PrEP for HIV prevention.

Antoine Khati, Michael Copenhaver, Ran Xu, Frederick L Altice, Jeffrey A Wickersham, Kamal Gautam, Kiran Paudel, Roman Shrestha

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of substance use and addiction treatment, 2025. 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. Review
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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

8 authors.

Antoine KhatiDepartment of Allied Health Sciences, University of Connecticut, Storrs, CT, USA.
Michael CopenhaverDepartment of Allied Health Sciences, University of Connecticut, Storrs, CT, USA.
Ran XuDepartment of Allied Health Sciences, University of Connecticut, Storrs, CT, USA.
Frederick L AlticeDepartment of Internal Medicine, Section of Infectious Diseases, Yale University School of Medicine, New Haven, CT, USA.
Jeffrey A WickershamDepartment of Internal Medicine, Section of Infectious Diseases, Yale University School of Medicine, New Haven, CT, USA.
Kamal GautamDepartment of Allied Health Sciences, University of Connecticut, Storrs, CT, USA.
Kiran PaudelDepartment of Allied Health Sciences, University of Connecticut, Storrs, CT, USA.
Roman ShresthaDepartment of Allied Health Sciences, University of Connecticut, Storrs, CT, USA; Department of Internal Medicine, Section of Infectious Diseases, Yale University School of Medicine, New Haven, CT, USA; Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA. Electronic address: roman.shrestha@uconn.edu.

Funding

Training in MHealth Prevention with MSMK01DA051346 · NIDA · YALE UNIVERSITY · PI SHRESTHA, ROMAN · 2020 to 2024
$862k
Integrated Rapid Access to HIV Prevention Program for People Who Inject Drugs (RAPID)R21DA051934 · NIDA · YALE UNIVERSITY · PI SHRESTHA, ROMAN · 2020 to 2021
$457k
NIDA NIH HHS K01 DA051346NIDA NIH HHS R21 DA051934
6 · The paper itself

Abstract

backgroundThe opioid crisis in the United States has led to climbing overdose rates, alongside HIV outbreaks among people who inject drugs (PWID). One area of the pre-exposure prophylaxis (PrEP) cascade that has received little attention is the persistence of PrEP, especially among PWID. To address this gap, this study examined the receipt, persistence, and factors associated with PrEP persistence among opioid-dependent PWID.

methodsBetween December 2020 and July 2022, we enrolled 100 opioid-dependent PWID. Eligible participants received a 90-day PrEP prescription from a community-based syringe services program and were followed up at 3 and 6 months. We assessed sociodemographic characteristics, PrEP use, and behaviors related to sex and drug use. We evaluated persistence on PrEP by calculating how many times each participant continued to pick up their PrEP prescription. To identify factors associated with persistence on PrEP, we used a multivariable ordinal logistic regression.

resultsOn average, participants were in their early 40s (mean age: 44.5, SD: 10.0 years), male (63.0 %), and unemployed (89.0 %). The majority (64.0 %) reported injecting drugs at least once per week in the past month, and 79.0 % had never used PrEP before. A total of 60 participants picked-up PrEP at least once during the 6-month follow-up period, with 42 (70.0 %) retrieving it only once, 16 (26.7 %) twice, and 2 (3.3 %) picking it up three times. In the multivariable model, unemployment (aOR = 7.819; 95 % CI: 1.538-39.751) and prior PrEP use (aOR = 3.381; 95 % CI: 1.210-9.443) were associated with higher persistence on PrEP, whereas participants who injected drugs once a week or less (aOR = 0.039; 95 % CI: 0.008-0.182) or more than once a week in the past month (aOR = 0.098; 95 % CI: 0.029-0.329) were less likely to consistently retrieve PrEP.

conclusionsDespite a high willingness to use PrEP among opioid-dependent, PrEP-naïve PWID in general, the adoption and persistence of PrEP were low in this study. Given that PWID represent a marginalized group at significant risk for HIV, these findings highlight the urgent need for comprehensive strategies to enhance the PrEP continuum of care by addressing the unique and diverse needs of this subgroup.

Indexed as

HIV InfectionsOpioid-Related DisordersPre-Exposure ProphylaxisSubstance Abuse, IntravenousAdministration, OralAdultFemaleHumansMaleMiddle AgedHIVOpioid use disorderPeople who inject drugsPre-exposure prophylaxisSyringe services program

Identifiers

PMID40222706
PMCPMC12477707

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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.