Daily Oral Pre-exposure Prophylaxis (PrEP) continuation among women from Durban, South Africa, who initiated PrEP as standard of care for HIV prevention in a clinical trial

Abstract

HIV incidence among women in Eastern and Southern Africa remains unacceptably high, highlighting the need for efective HIV prevention options, including pre-exposure prophylaxis (PrEP). The Evidence for contraceptive Options and HIV Outcomes trial ofered daily oral PrEP to participants during the latter part of the clinical trial as an additional HIV prevention choice. We explored daily oral PrEP continuation at trial exit among women enrolled from Durban, South Africa who initiated oral PrEP at the trial site. Of the 132 women initiating oral PrEP, 87% reported continuation of oral PrEP at month 1, 80% at month 3, and 75% continued using oral PrEP at their fnal trial visit and were referred to of-site facilities for ongoing oral PrEP access. The median duration of oral PrEP use in trial participants who used oral PrEP was 91 days (IQR 87 to 142 days). Women who disclosed their oral PrEP use to someone had increased odds of continuing oral PrEP at trial exit. Women who reported>1 sex partner and those who felt they would probably or defnitely get infected with HIV had reduced odds of continuing oral PrEP at trial exit. Of those discontinuing oral PrEP (n=32),>50% discontinued within the frst month, and the most common reason for discontinuation was reporting side efects. The high rates of oral PrEP continuation in our study are encouraging and our fndings can be utilized by other clinical trials providing oral PrEP as standard of care for HIV prevention and by oral PrEP implementation programmes.