Predictors of PrEP Retention in at Risk Patients Seen at a HIV Primary Care Clinic in San Diego

Background: Adherence to medication and retention in care are key contributors to the efficacy of pre-exposure prophylaxis (PrEP) for prevention of HIV. Therefore, it is important to understand factors that may impact retention in various settings that prescribe PrEP.

Methods: We evaluated factors associated with retention in care 3 and 12 months after PrEP initiation at a primary care HIV clinic in San Diego. Retention was defined as having an office/virtual visit within 1 month from the 3- or 12-months time point or interacting with the clinic leading to medication being refilled.

Results: A total of 199 patients were included. Retention rates were 74.4% and 52.8% at 3 and 12 months respectively. In the multivariate analysis, reporting depression or anxiety was associated with being retained in care ( = 0.004) and identifying as cisgender female was associated with lack of retention ( = 0.04) at 3 months. Testing positive for a sexually transmitted infection was associated with 12-months retention ( = 0.004); however, this was likely influenced by difference in the frequency of testing in those retained versus not retained.

Conclusion: Ongoing efforts to determine the optimal method for provision of PrEP care that supports retention for different populations at risk for HIV, are needed.