Background and importance The Spanish National Health System agreed to finance emtricitacin/tenofovir (FTC/TDF) in November 2019 with an indication of pre-exposure prophylaxis (PrEP) as an HIV prevention measure. PrEP consists of taking one FTC/TDF tablet daily. The role of hospital pharmacist in the treatment of HIV-negative individuals is to follow up by monitoring adherence, interactions and reasons for discontinuation of treatment.
Aim and objectives To describe the use of FTC/TDF for PrEP in a tertiary hospital and follow-up of candidate HIV-negative individuals from the start of therapy.
Material and methods Retrospective, observational and Hospital ID Clinic study including all non-infected individuals who started treatment from December 2019 to April 2021.
Variables analysed: age, sex, risk behaviours, persistence, treatment duration, treatment withdrawal reason, adherence (adherent if ≥95%) and reasons for low adherence.
Data were obtained from the electronic medical records and outpatient dispensing module.
Results Eighty-eight HIV-negative individuals were included, 98% (86/88) were men, all of them being men practising sex with men (MSM). The mean age was 40±9 years.
Persistence to treatment (mean persistence = 6 months) was 91% (80/88). The remaining 9% (8/88) abandoned the treatment. The reasons for dropping out were: 4/8 adverse reactions (AR) (3 gastrointestinal complaints and 1 renal toxicity), 1/8 absence of risky sexual practices (= stable partner), 1/8 lockdown and 2/8 unidentified due to lack of follow-up.
82% of the non-infected people were adherent to treatment, being the mean adherence to treatment 95%. The mean adherence of the individuals considered non-adherent was 76%. The reasons for poor adherence were: 3/14 gastrointestinal AR (flatulence and abdominal pain), 1/14 absence of risky sexual relations, 1/14 lockdown and 9/14 unidentified due to lack of follow-up.
Conclusion and relevance The main profile of HIV-negative individuals in treatment with PrEP is MSM.
In general, both persistence and adherence to treatment were good. However, considering the short duration of treatment, a long-term study should be performed.
Results show that the most frequent reasons for treatment withdrawal and low adherence are AR.
Conflict of interest No conflict of interest