HIV Pre-exposure Prophylaxis (PrEP) Uptake and Persistence in Wartime Ukraine: Analysis of Data from a Scaled PrEP Program.

IF 2.4 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

AIDS and Behavior Pub Date : 2025-06-11 DOI:10.1007/s10461-025-04773-0

Ellis G Moon, Alyona P Ihnatiuk, Anna P Kazanzhy, Oksana V Danylenko, Larisa I Hetman, Lisa E Manhart, Misti R Mcdowell, Anna Y Shapoval, Nancy H Puttkammer

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引用次数: 0

Abstract

Russia's invasion of Ukraine and the ongoing war have had devastating effects on health programs. This observational study assessed uptake and persistent use of HIV pre-exposure prophylaxis (PrEP) during wartime. The study included newly-initiating daily PrEP users from 94 clinics who enrolled on PrEP from October 2022 through September 2023. PrEP persistence was defined as returning for a PrEP refill no later than 7 days after the expected refill date. We used Kaplan-Meier curves and sex-stratified Cox regression to explore PrEP discontinuation by sex, key population group, age group, and wartime location. 4537 clients initiated daily PrEP, with 31.9% being men who have sex with men (MSM), 29.7% based in a frontline location, and 16.7% aged 18-25. Six-month persistence was 37.3% overall. It was lower among MSM (28.6%), young adults aged 18-25 (17.2%), and frontline residents (15.6%), and higher among sex workers (SW) (81.5%). In adjusted analysis among women, SW had a lower risk of discontinuing PrEP compared with discordant couples (adjusted hazard ratio [aHR]: 0.22, 95% confidence interval [CI] 0.14-0.34). In both sexes, clients aged 18-25 had a higher risk of discontinuing PrEP (aHR: 1.43, 95% CI 1.25-1.65 for men; aHR: 1.60, 95% CI 1.16-2.20 for women), as did those based in frontline locations (aHR: 2.19, 95% CI 1.99-2.41 for men; aHR: 1.26, 95% CI 1.04-1.53 for women). The findings highlight the resilience of Ukraine's PrEP program and the need to support PrEP persistence among younger and frontline populations.

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艾滋病毒暴露前预防（PrEP）的吸收和持续在战时乌克兰：数据分析从一个规模PrEP计划。

俄罗斯入侵乌克兰和正在进行的战争对医疗项目造成了毁灭性的影响。这项观察性研究评估了战时艾滋病毒暴露前预防（PrEP）的吸收和持续使用情况。该研究包括来自94家诊所的新开始的每日PrEP使用者，他们从2022年10月到2023年9月登记使用PrEP。PrEP持续性定义为在预期补充日期后不迟于7天返回进行PrEP补充。我们使用Kaplan-Meier曲线和性别分层Cox回归来探讨按性别、重点人群、年龄组和战时地点停用PrEP的情况。4537名客户开始了每日PrEP，其中31.9%是男男性行为者（MSM）， 29.7%在一线，16.7%在18-25岁之间。6个月的持续时间总体为37.3%。男男性接触者（28.6%）、18-25岁年轻人（17.2%）和一线居民（15.6%）的感染率较低，性工作者（SW）的感染率较高（81.5%）。在女性的调整分析中，与不一致的夫妇相比，夫妻二人停止PrEP的风险更低（调整风险比[aHR]: 0.22, 95%可信区间[CI] 0.14-0.34）。在两性中，18-25岁的患者停止PrEP的风险更高(男性的aHR: 1.43, 95% CI 1.25-1.65；aHR: 1.60，女性95% CI 1.16-2.20)，前线工作人员也是如此(aHR: 2.19，男性95% CI 1.99-2.41；aHR: 1.26，女性95% CI 1.04-1.53)。研究结果强调了乌克兰PrEP项目的韧性，以及支持年轻和一线人群持续接受PrEP的必要性。

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来源期刊

AIDS and Behavior Multiple-

CiteScore

6.60

自引率

13.60%

发文量

382

期刊介绍： AIDS and Behavior provides an international venue for the scientific exchange of research and scholarly work on the contributing factors, prevention, consequences, social impact, and response to HIV/AIDS. This bimonthly journal publishes original peer-reviewed papers that address all areas of AIDS behavioral research including: individual, contextual, social, economic and geographic factors that facilitate HIV transmission; interventions aimed to reduce HIV transmission risks at all levels and in all contexts; mental health aspects of HIV/AIDS; medical and behavioral consequences of HIV infection - including health-related quality of life, coping, treatment and treatment adherence; and the impact of HIV infection on adults children, families, communities and societies. The journal publishes original research articles, brief research reports, and critical literature reviews. provides an international venue for the scientific exchange of research and scholarly work on the contributing factors, prevention, consequences, social impact, and response to HIV/AIDS. This bimonthly journal publishes original peer-reviewed papers that address all areas of AIDS behavioral research including: individual, contextual, social, economic and geographic factors that facilitate HIV transmission; interventions aimed to reduce HIV transmission risks at all levels and in all contexts; mental health aspects of HIV/AIDS; medical and behavioral consequences of HIV infection - including health-related quality of life, coping, treatment and treatment adherence; and the impact of HIV infection on adults children, families, communities and societies. The journal publishes original research articles, brief research reports, and critical literature reviews.5 Year Impact Factor: 2.965 (2008) Section ''SOCIAL SCIENCES, BIOMEDICAL'': Rank 5 of 29 Section ''PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH'': Rank 9 of 76