Predictors of PrEP retention in at risk patients seen at a HIV primary care clinic in San Diego

Abstract

Background Adherence to medication and retention in care are key contributors to the efficacy of pre-exposure prophylaxis (PrEP) for prevention of HIV. Therefore, it is important to understand factors that may impact retention in various settings that prescribe PrEP. Methods We evaluated factors associated with retention in care 3 and 12 months after PrEP initiation at a primary care HIV clinic in San Diego. Retention was defined as having an office/virtual visit within 1 month from the 3- or 12-months time point or interacting with the clinic leading to medication being refilled. Results A total of 199 patients were included. Retention rates were 74.4% and 52.8% at 3 and 12 months respectively. In the multivariate analysis, reporting depression or anxiety was associated with being retained in care ( p = 0.004) and identifying as cisgender female was associated with lack of retention ( p = 0.04) at 3 months. Testing positive for a sexually transmitted infection was associated with 12-months retention ( p = 0.004); however, this was likely influenced by difference in the frequency of testing in those retained versus not retained. Conclusion Ongoing efforts to determine the optimal method for provision of PrEP care that supports retention for different populations at risk for HIV, are needed.