Patrick S Sullivan1, Robertino Mera Giler2, Farah Mouhanna3, Elizabeth S Pembleton4, Jodie L Guest4, Jeb Jones4, Amanda D Castel5, Howa Yeung6, Michael Kramer4, Scott McCallister2, Aaron J Siegler4. 1. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA. Electronic address: patrick.sullivan@emory.edu. 2. Pharmacovigilance & Epidemiology, Gilead Sciences, Foster City, CA. 3. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA; Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, The George Washington University, Washington, DC. 4. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA. 5. Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, The George Washington University, Washington, DC. 6. Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, GA.
Abstract
PURPOSE: Pre-exposure prophylaxis (PrEP) with oral emtricitibine/tenofovir disoproxil fumarate (TDF/FTC) reduces the risk of HIV infection by >90% when taken as prescribed. Trends in prevalence of PrEP use, which account for persons who have stopped PrEP, increased through 2016, but have not been described since. METHODS: Annual prevalence estimates of unique, TDF/FTC PrEP users (individuals with ≥1 day of a filled PrEP prescription in a given year) in the United States (US) were generated for 2012-2017 from a national prescription database. A validated algorithm was used to distinguish users of TDF/FTC for HIV or chronic Hepatitis B treatment or postexposure prophylaxis from PrEP users. We calculated annual prevalence of PrEP use overall and by age, sex, and region. We used log-transformation to calculate estimated annual percent change (EAPC) in the prevalence of PrEP use. RESULTS: Annual prevalence of PrEP use increased from 3.3/100,000 population in 2012 to 36.7 in 2017 -a 56% annual increase from 2012 to 2017 (EAPC: +56%). Annual prevalence of PrEP use increased faster among men than among women (EAPC: +68% and +5%, respectively). By age group, annual prevalence of PrEP use increased fastest among 25- to 34-year olds (EAPC: +61%) and slowest among ≥55-year olds (EAPC: +52%) and ≤24-year olds (EAPC: +51%). In 2017, PrEP use was lowest in the South (29.8/100,000) and highest in the Northeast (62.3/100,000). CONCLUSIONS: Despite overall increases in the annual number of TDF/FTC PrEP users in the US from 2012 to 2017, the growth of PrEP coverage is inconsistent across groups. Efforts to optimize PrEP access are especially needed for women and for those living in the South.
PURPOSE: Pre-exposure prophylaxis (PrEP) with oral emtricitibine/tenofovir disoproxil fumarate (TDF/FTC) reduces the risk of HIV infection by >90% when taken as prescribed. Trends in prevalence of PrEP use, which account for persons who have stopped PrEP, increased through 2016, but have not been described since. METHODS: Annual prevalence estimates of unique, TDF/FTC PrEP users (individuals with ≥1 day of a filled PrEP prescription in a given year) in the United States (US) were generated for 2012-2017 from a national prescription database. A validated algorithm was used to distinguish users of TDF/FTC for HIV or chronic Hepatitis B treatment or postexposure prophylaxis from PrEP users. We calculated annual prevalence of PrEP use overall and by age, sex, and region. We used log-transformation to calculate estimated annual percent change (EAPC) in the prevalence of PrEP use. RESULTS: Annual prevalence of PrEP use increased from 3.3/100,000 population in 2012 to 36.7 in 2017 -a 56% annual increase from 2012 to 2017 (EAPC: +56%). Annual prevalence of PrEP use increased faster among men than among women (EAPC: +68% and +5%, respectively). By age group, annual prevalence of PrEP use increased fastest among 25- to 34-year olds (EAPC: +61%) and slowest among ≥55-year olds (EAPC: +52%) and ≤24-year olds (EAPC: +51%). In 2017, PrEP use was lowest in the South (29.8/100,000) and highest in the Northeast (62.3/100,000). CONCLUSIONS: Despite overall increases in the annual number of TDF/FTC PrEP users in the US from 2012 to 2017, the growth of PrEP coverage is inconsistent across groups. Efforts to optimize PrEP access are especially needed for women and for those living in the South.
Authors: Jeffrey T Parsons; H Jonathon Rendina; Jonathan M Lassiter; Thomas H F Whitfield; Tyrel J Starks; Christian Grov Journal: J Acquir Immune Defic Syndr Date: 2017-03-01 Impact factor: 3.731
Authors: Patrick S Sullivan; Alex Carballo-Diéguez; Thomas Coates; Steven M Goodreau; Ian McGowan; Eduard J Sanders; Adrian Smith; Prabuddhagopal Goswami; Jorge Sanchez Journal: Lancet Date: 2012-07-20 Impact factor: 79.321
Authors: Julia L Marcus; Leo B Hurley; Charles Bradley Hare; Dong Phuong Nguyen; Tony Phengrasamy; Michael J Silverberg; Juliet E Stoltey; Jonathan E Volk Journal: J Acquir Immune Defic Syndr Date: 2016-12-15 Impact factor: 3.731
Authors: Myron S Cohen; Ying Q Chen; Marybeth McCauley; Theresa Gamble; Mina C Hosseinipour; Nagalingeswaran Kumarasamy; James G Hakim; Johnstone Kumwenda; Beatriz Grinsztejn; Jose H S Pilotto; Sheela V Godbole; Sanjay Mehendale; Suwat Chariyalertsak; Breno R Santos; Kenneth H Mayer; Irving F Hoffman; Susan H Eshleman; Estelle Piwowar-Manning; Lei Wang; Joseph Makhema; Lisa A Mills; Guy de Bruyn; Ian Sanne; Joseph Eron; Joel Gallant; Diane Havlir; Susan Swindells; Heather Ribaudo; Vanessa Elharrar; David Burns; Taha E Taha; Karin Nielsen-Saines; David Celentano; Max Essex; Thomas R Fleming Journal: N Engl J Med Date: 2011-07-18 Impact factor: 91.245
Authors: Jared M Baeten; Deborah Donnell; Patrick Ndase; Nelly R Mugo; James D Campbell; Jonathan Wangisi; Jordan W Tappero; Elizabeth A Bukusi; Craig R Cohen; Elly Katabira; Allan Ronald; Elioda Tumwesigye; Edwin Were; Kenneth H Fife; James Kiarie; Carey Farquhar; Grace John-Stewart; Aloysious Kakia; Josephine Odoyo; Akasiima Mucunguzi; Edith Nakku-Joloba; Rogers Twesigye; Kenneth Ngure; Cosmas Apaka; Harrison Tamooh; Fridah Gabona; Andrew Mujugira; Dana Panteleeff; Katherine K Thomas; Lara Kidoguchi; Meighan Krows; Jennifer Revall; Susan Morrison; Harald Haugen; Mira Emmanuel-Ogier; Lisa Ondrejcek; Robert W Coombs; Lisa Frenkel; Craig Hendrix; Namandjé N Bumpus; David Bangsberg; Jessica E Haberer; Wendy S Stevens; Jairam R Lingappa; Connie Celum Journal: N Engl J Med Date: 2012-07-11 Impact factor: 91.245
Authors: Patrick S Sullivan; Eli S Rosenberg; Travis H Sanchez; Colleen F Kelley; Nicole Luisi; Hannah L Cooper; Ralph J Diclemente; Gina M Wingood; Paula M Frew; Laura F Salazar; Carlos Del Rio; Mark J Mulligan; John L Peterson Journal: Ann Epidemiol Date: 2015-03-24 Impact factor: 3.797
Authors: Julia L Marcus; Kenneth Levine; Chris Grasso; Douglas S Krakower; Victoria Powell; Kenneth H Mayer Journal: Am J Public Health Date: 2018-12 Impact factor: 9.308
Authors: Jose Carlo Hojilla; Derek D Satre; David V Glidden; Vanessa M McMahan; Monica Gandhi; Patricia Defechereux; Juan V Guanira; Megha Mehrotra; Robert M Grant; Adam W Carrico Journal: J Acquir Immune Defic Syndr Date: 2019-05-01 Impact factor: 3.731
Authors: Kevin M Maloney; Adrien Le Guillou; Robert A Driggers; Supriya Sarkar; Emeli J Anderson; Amyn A Malik; Samuel M Jenness Journal: J Infect Dis Date: 2021-01-04 Impact factor: 5.226
Authors: Julia Raifman; Kristen Nocka; Omar Galárraga; Ira B Wilson; Christina Crowley; Jun Tao; Siena Napoleon; Theodore Marak; Philip A Chan Journal: Ann Epidemiol Date: 2020-03-26 Impact factor: 3.797
Authors: Dawn K Smith; Patrick S Sullivan; Betsy Cadwell; Lance A Waller; Azfar Siddiqi; Robertino Mera-Giler; Xiaohong Hu; Karen W Hoover; Norma S Harris; Scott McCallister Journal: Clin Infect Dis Date: 2020-12-15 Impact factor: 9.079