Discontinuous PrEP Use Increases Likelihood of HIV Seroconversion

Discontinuous use of PrEP may increase the likelihood of HIV acquisition among youth at high risk for HIV, according to findings published in JAIDS. Dallas Swendeman, PhD, MPH, and colleagues assessed the relationship between HIV seroconversion and PrEP uptake, adherence, and continuity among 895 youth at risk for HIV infection in Los Angeles and New Orleans. The diverse study sample (40% Black; 28% Latine; 20% White) included mostly cisgender gay/bisexual male youth (79%) as well as transmasculine/non-binary youth (14%) and transgender female youth (7%). Selfreported weekly PrEP adherence was high (98%). In total, 27 participants acquired HIV during the study period, and HIV incidence among PrEP users (3.12 cases per 100 person-years) was higher than in those who never taken PrEP (2.53 cases per 100 person-years). Seroconversion was highest among PrEP users with discontinuous use (3.36 cases per 100 person-years). “If oral PrEP users were adherent using 2-monthly long-acting injectables, our estimate suggests 2.06 infections per 100 [person-years] could be averted,” Dr. Swendeman and colleagues wrote.