Predictors of Re-Initiation of Daily Oral Preexposure Prophylaxis Regimen After Discontinuation

Abstract

Daily oral preexposure prophylaxis (PrEP) for reducing HIV transmission is recommended for those at elevated risk, including sexual gender and minorities assigned male at birth (SGM-AMAB). Few studies have examined re-initiation among PrEP discontinuers, which is critical to ensuring optimization of PrEP’s protection. The current study examined predictors of re-initiation in a longitudinal sample of SGM-AMAB PrEP discontinuers (n = 253) from 10 waves of an ongoing cohort study (analytic n = 1,129). Multilevel structural equation models were used to examine the effects of psycho-social variables on re-initiation. In adjusted models, health insurance, and partner HIV positive status were significantly positively associated with PrEP re-initation. Being bisexual was significantly negatively associated with re-initiation relative to gay participants. Single status and open relationship agreements were associated with higher odds of re-initiation relative to monogamous relationships. Findings suggest that demographic, partnership characteristics and structural factors influence decisions to re-initiate PrEP after discontinuation.