Pre-exposure prophylaxis for HIV high-risk groups: An analysis of clinical compliance / 第二军医大学学报

ABSTRACT

Objective: To investigate the factors influencing the compliance of pre-exposure prophylaxis (PrEP) among high-risk groups of human immunodeficiency virus (HIV). Methods: A total of 352 subjects were selected into the cohort by non-probability sampling, including 153 men who have sex with men (MSM), 36 female sex workers (FSMs), and 163 fixed sex partners(PARs) of HIV carriers. Each subject was randomly given a medication regimen of either once daily or twice a week. The pre-exposure prophylaxis compliance was evaluated by observing the maintenance of the cohort and medication omission every 4 weeks from week 0 to week 28. Cochran-Mantel-Haenszel (CMH) test was employed to conduct univariate analysis and logistic regression was adopted for multiple variable analysis. Results: It was found that 76. 70% (270/352) of the subjects finished the 28-week-observation in this PrEP clinical trial among high-risk groups of HIV. The medication omission rate fluctuated around 35% during the follow-up, with the total compliance score being 82. 12 ± 27. 48 and the median score being 95. 24. Logistic regression suggested that the monthly income, presence of worries or difficulties during the trials, need for medical service, and the way of follow-up were the factors influencing the maintenance of cohort. The marital status, medication method, presence of worries or difficulties during the trial, and presence of adverse effect were the influencing factors of medication omission. The population typ e, number of sex partners, taking of other drugs at the same time, need of medical service during the trial, and way of follow-up were the factors impacting the overall compliance score. Conclusion: The compliance of the present PrEP clinical trials among high-risk groups of HIV is high, and it has multiple influencing factors. Compliance management should be reinforced among MSM and FSW populations with greater motility. The cohort management model of follow-up by fixed specialists should be continued with more frequent follow-up; meanwhile, classified management should be implemented for individuals with different characters, so as to ensure a good compliance during the clinical trials.