Impact of changing pre-exposure prophylaxis regimens on retention among men who have sex with men in Hanoi, Vietnam (2020−2023): a cohort study

IF 4.9 1区医学 Q2 IMMUNOLOGY

Journal of the International AIDS Society Pub Date : 2025-07-02 DOI:10.1002/jia2.26478

Naira Setrakian, Hao Thi Minh Bui, Paul C. Adamson, Thai N. Hoang, Pamina M. Gorbach, Le Minh Giang

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引用次数: 0

Abstract

Introduction

We examined the association of pre-exposure prophylaxis (PrEP) programme retention with the use of daily, event-driven (ED) or regimen switching reported during follow-up at any point prior to discontinuation among men who have sex with men (MSM) in Hanoi, Vietnam.

Methods

Between April 2020 and February 2023, we collected data from PrEP clients at Hanoi Medical University Sexual Health Promotion clinic who were prescribed either ED or daily PrEP at the initial visit; at subsequent visits, clients reported the regimen used since the prior visit. We defined three categories of PrEP use: ED-PrEP exclusively, daily PrEP exclusively and switching regimens. The primary outcome was time to discontinuation in the PrEP programme during the study period, defined as missing a scheduled visit by > 30 days. We performed survival analysis using Kaplan−Meier curves.

Results

In total, 2107 people were included: 61.1% (n = 1288) reported exclusive use of daily PrEP, 10.4% (n = 220) reported exclusive use of ED-PrEP and 28.4% (n = 599) reported switching PrEP regimens. Among switchers, 29.40% (n = 176) switched more than once. Furthermore, 82.5% switched from daily to ED-PrEP and 17.5% switched from ED to daily PrEP. The median time to discontinuation in the PrEP programme was 105 days (IQR: 52−182) among those reporting exclusive use of ED-PrEP, 104 days (IQR: 56−274) among those reporting exclusive use of daily PrEP and 163 days (IQR: 101−308) among those who switched. Among switchers, those who switched more than once had a median time to discontinuation in the PrEP programme of 231 days (IQR: 137−380) in comparison to 133 days (IQR: 90−274) for those who switched once.

Conclusions

We provide real-world data from MSM in an HIV PrEP programme in Vietnam that those who switched had longer periods of retention during the study period. Our findings suggest that offering flexible PrEP regimen options may improve engagement and long-term adherence among this population.

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改变暴露前预防方案对越南河内（2020 - 2023）男男性行为者滞留的影响：一项队列研究

我们检查了暴露前预防（PrEP）计划保留与每日使用、事件驱动（ED）或方案转换的关系，在越南河内的男男性行为者（MSM）中，在停药前的任何时间点随访期间报告。方法在2020年4月至2023年2月期间，我们收集了河内医科大学性健康促进诊所的PrEP患者的数据，这些患者在初次就诊时被开ED或每日PrEP；在随后的访问中，客户报告了自上次访问以来使用的方案。我们定义了PrEP使用的三种类型：ED-PrEP专用、每日PrEP专用和转换方案。主要结果是研究期间PrEP项目停止的时间，定义为错过预定的访问；30天。我们使用Kaplan - Meier曲线进行生存分析。结果共纳入2107人：61.1% （n = 1288）报告完全使用每日PrEP， 10.4% （n = 220）报告完全使用ED-PrEP， 28.4% （n = 599）报告切换PrEP方案。在转换者中，29.40% （n = 176）的转换次数超过一次。此外，82.5%的患者从每日使用ED-PrEP转为每日使用ED-PrEP， 17.5%的患者从ED-PrEP转为每日使用PrEP。仅使用ED-PrEP的患者到停止使用PrEP的中位时间为105天（IQR: 52 - 182），仅使用每日使用PrEP的患者为104天（IQR: 56 - 274），而改用PrEP的患者为163天（IQR: 101 - 308）。在转换者中，转换一次以上的人到停止PrEP计划的中位时间为231天（IQR: 137 - 380），而转换一次的人为133天（IQR: 90 - 274）。结论：我们提供了来自越南HIV PrEP项目中男男性行为者的真实数据，这些人在研究期间的保留时间更长。我们的研究结果表明，提供灵活的PrEP方案选择可能会提高这一人群的参与度和长期依从性。

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

Journal of the International AIDS Society IMMUNOLOGY-INFECTIOUS DISEASES

CiteScore

8.60

自引率

10.00%

发文量

186

审稿时长

>12 weeks

期刊介绍： The Journal of the International AIDS Society (JIAS) is a peer-reviewed and Open Access journal for the generation and dissemination of evidence from a wide range of disciplines: basic and biomedical sciences; behavioural sciences; epidemiology; clinical sciences; health economics and health policy; operations research and implementation sciences; and social sciences and humanities. Submission of HIV research carried out in low- and middle-income countries is strongly encouraged.