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Objective <p>To analyze factors associated with the discontinuation of pre-exposure prophylaxis (PrEP) for HIV among users in Brazil.</p> Methods <p>An analytical case-control study was conducted using retrospective data (2018–2020) from PrEP users monitored by Brazil’s Unified Health System (SUS) via the Medicines Logistics Control System (SICLOM). Cases (interrupted PrEP, <i>n</i> = 629) were matched 1:10 by sex at birth and age to controls (maintained PrEP, <i>n</i> = 6290). Logistic regression identified factors associated with discontinuation.</p> Results <p>Factors significantly associated with PrEP discontinuation included previous anal lesions (adjusted Odds Ratio: 1.92; 95% Confidence Interval [CI]: 1.06–3.28; <i>p</i> = 0.022), active infections within the first 30 days of PrEP (aOR: 1.51; 95% CI 1.07–2.07; <i>p</i> = 0.014), and frequent medication forgetfulness (aOR: 1.48; 95% CI 1.19–1.84; <i>p</i> &lt; 0.001). Not experiencing adverse effects during the first month was protective (aOR: 0.73; 95% CI 0.61–0.87; <i>p</i> &lt; 0.001). The median time until discontinuation was 8 months.</p> Conclusion <p>Early clinical experiences and adherence behaviors are critical for PrEP continuation. Enhanced support and monitoring, particularly in the first 30 days post-initiation, are pivotal to improve PrEP persistence in Brazil.</p>

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Factors associated with interrupted pre-exposure prophylaxis (PrEP) in a Brazilian cohort: a brief communication

  • 期刊论文

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  • 发表日期：

    2025年8月21日

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  • Patricia Matias Pinheiro,
  • Nathalia Pedrosa Lima,
  • Angelica Espinosa Miranda,
  • Valbert Oliveira Costa Filho,
  • Igor Pacheco Fiuza Romeiro,
  • Hermano Alexandre Lima Rocha,
  • Wildo Navegantes de Araújo

摘要

Objective

To analyze factors associated with the discontinuation of pre-exposure prophylaxis (PrEP) for HIV among users in Brazil.

Methods

An analytical case-control study was conducted using retrospective data (2018–2020) from PrEP users monitored by Brazil’s Unified Health System (SUS) via the Medicines Logistics Control System (SICLOM). Cases (interrupted PrEP, n = 629) were matched 1:10 by sex at birth and age to controls (maintained PrEP, n = 6290). Logistic regression identified factors associated with discontinuation.

Results

Factors significantly associated with PrEP discontinuation included previous anal lesions (adjusted Odds Ratio: 1.92; 95% Confidence Interval [CI]: 1.06–3.28; p = 0.022), active infections within the first 30 days of PrEP (aOR: 1.51; 95% CI 1.07–2.07; p = 0.014), and frequent medication forgetfulness (aOR: 1.48; 95% CI 1.19–1.84; p < 0.001). Not experiencing adverse effects during the first month was protective (aOR: 0.73; 95% CI 0.61–0.87; p < 0.001). The median time until discontinuation was 8 months.

Conclusion

Early clinical experiences and adherence behaviors are critical for PrEP continuation. Enhanced support and monitoring, particularly in the first 30 days post-initiation, are pivotal to improve PrEP persistence in Brazil.