Dynamics Of Pre-Exposure (PrEP) Eligibility due to Waxing and Waning of HIV Risk in Rakai, Uganda

We conducted a retrospective population-based study to describe longitudinal patterns of prevalence, incidence, discontinuation, resumption, and durability of substantial HIV risk behaviors (SHR) for PrEP eligibility.The study was conducted among HIV-negative study participants aged 15-49 years that participated in survey rounds of the Rakai Community Cohort Study between August 2011 and June 2018. SHR was defined based on the Uganda national PrEP eligibility as either reporting sexual intercourse with >1 partner of unknown HIV status, non-marital sex without a condom or having transactional sex. Resumption of SHR meant resuming of SHR after stopping SHR, while persistence of SHR meant SHR on >1 consecutive visit. We used generalized estimation equations (GEE) with log-binomial regression models and robust variance to estimate survey-specific prevalence ratios (PR); GEE with modified Poisson regression models and robust variance to estimate incidence ratios for incidence, discontinuation, and resumption of PrEP eligibility.PrEP use should be tailored to the dynamic nature of PrEP eligibility. Preventive-effective adherence should be adopted for assessment of attrition in PrEP programs.
Waxing and Waning, Pre-Exposure, HIV
Ssempijja, V., Ssekubugu, R., Kigozi, G., Nakigozi, G., Kagaayi, J., Ekstrom, A. M., ... & Reynolds, S. J. (2022). DYNAMICS OF PRE-EXPOSURE (PrEP) ELIGIBILITY DUE TO WAXING AND WANING OF HIV RISK IN RAKAI, UGANDA. JAIDS Journal of Acquired Immune Deficiency Syndromes, 10-1097.DOI: 10.1097/QAI.0000000000003182