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<p>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&#xa0;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.</p>

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

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年6月11日

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  • 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

摘要

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.