Trends in HIV preexposure prophylaxis use before and after launch of the Ending the HIV Epidemic in the U.S. initiative, 2016-2023.

IF 2.9 3区医学 Q3 IMMUNOLOGY

JAIDS Journal of Acquired Immune Deficiency Syndromes Pub Date : 2025-04-08 DOI:10.1097/QAI.0000000000003674

Weiming Zhu, Ya-Lin A Huang, Athena P Kourtis, Robyn Neblett-Fanfair, Jonathan Mermin, Karen W Hoover

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Abstract

Introduction: The Ending the HIV Epidemic in the U.S. (EHE) initiative was launched by the U.S. Department of Health and Human Services in 2019 with the goal of decreasing new HIV infections 90% by 2030. Increasing the use of HIV preexposure prophylaxis (PrEP) is one of the EHE strategies. We assessed the impact of EHE activities on PrEP use.

Methods: Using IQVIA Real-world longitudinal prescription data and the National HIV Surveillance System data, we calculated jurisdiction-level PrEP to diagnosis ratios (PDRs) in the United States from 2016-2023. We assessed impact of EHE with a difference-in-difference (DID) analysis.

Results: The PDR increased from 3.0 to 14.7 in EHE Jurisdictions; from 1.2 to 7.2 in EHE states; and from 2.5 to 13.4 in non-EHE jurisdictions. On average, no additional increase in the PDR was found for EHE counties compared with matched non-EHE counties, (adjusted DID: 0.2, 95% confidence interval [CI]: -1.0∼1.3), or for EHE states (adjusted DID: 0.4, 95% CI: -1.6∼2.4).

Conclusions: Overall PrEP use increased markedly, with some EHE jurisdictions achieving greater increases than non-EHE jurisdictions with similar PDRs in 2019. The uneven increase in PrEP use in EHE jurisdictions underscores the need for jurisdiction-specific PrEP implementation strategies designed for the needs of each community. It also underscores the need for sufficient funding to accomplish EHE goals.

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导言：美国卫生与公众服务部于 2019 年发起了 "终结美国艾滋病毒流行"（EHE）倡议，目标是到 2030 年将新增艾滋病毒感染率降低 90%。增加艾滋病毒暴露前预防（PrEP）的使用是 EHE 战略之一。我们评估了 EHE 活动对 PrEP 使用的影响：利用 IQVIA Real-world 纵向处方数据和美国国家艾滋病监测系统数据，我们计算了 2016-2023 年美国辖区一级的 PrEP 诊断比率 (PDR)。我们通过差异分析（DID）评估了 EHE 的影响：在 EHE 辖区，PDR 从 3.0 增加到 14.7；在 EHE 州，PDR 从 1.2 增加到 7.2；在非 EHE 辖区，PDR 从 2.5 增加到 13.4。平均而言，与匹配的非 EHE 县相比，EHE 县的 PDR 没有额外增加（调整后的 DID：0.2，95% 置信区间 [CI]：-1.0∼1.3），EHE 州的 PDR 也没有额外增加（调整后的 DID：0.4，95% CI：-1.6∼2.4）：PrEP的总体使用率显著增加，2019年，一些EHE辖区的使用率增幅大于具有类似PDR的非EHE辖区。EHE辖区PrEP使用率的不均衡增长凸显了针对各社区需求制定特定辖区PrEP实施策略的必要性。这也凸显了为实现 EHE 目标提供充足资金的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JAIDS Journal of Acquired Immune Deficiency Syndromes 医学-传染病学

CiteScore

5.80

自引率

5.60%

发文量

490

审稿时长

3-6 weeks

期刊介绍： JAIDS: Journal of Acquired Immune Deficiency Syndromes seeks to end the HIV epidemic by presenting important new science across all disciplines that advance our understanding of the biology, treatment and prevention of HIV infection worldwide. JAIDS: Journal of Acquired Immune Deficiency Syndromes is the trusted, interdisciplinary resource for HIV- and AIDS-related information with a strong focus on basic and translational science, clinical science, and epidemiology and prevention. Co-edited by the foremost leaders in clinical virology, molecular biology, and epidemiology, JAIDS publishes vital information on the advances in diagnosis and treatment of HIV infections, as well as the latest research in the development of therapeutics and vaccine approaches. This ground-breaking journal brings together rigorously peer-reviewed articles, reviews of current research, results of clinical trials, and epidemiologic reports from around the world.