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

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.