OBJECTIVES : In February 2019, the US Department of Health and Human Services proposed a strategic initiative to end human immunodeficiency virus (HIV) epidemic in the US by reducing new HIV infections by 90% in 2020–2030. One of the 4 pillars of the initiative is protecting persons at risk for HIV infection using HIV PrEP (antiretrovirals proven effective at preventing infection among persons at risk). We investigated PrEP uptake, adherence, and discontinuation among patients in care at 11 large geographically distributed US HIV treatment centers.

METHODS : Trio Health HIV Research Network containing electronic medical records for over 130,000 HIV and non-HIV patients was used for the study. PrEP patient registry contains nearly 9,000 patients with PrEP prescriptions and over 5,000 with PrEP dispenses.

RESULTS : Of 5,223 adults with PrEP dispensing data, 66% were male, 4% female, <1% transgender, and 30% unspecified gender; 59% were white, 12% black, 10% other race, 19% unknown; 86% were age <50 at PrEP initiation. Emtricitabine/tenofovir disoproxil fumarate (FTC/TDF) was dispensed to 81% of patients, FTC/tenofovir alafenamide (TAF) to 47%. Average PrEP duration was 10.2 mo (SD 9.9): 12 mo (11.6) FTC/TDF, 7.2 mo (4.4) FTC/TAF. Average medication possession ratio was 88%: 87% for FTC/TDF, 93% for FTC/TAF.

CONCLUSIONS : Trio Health HIV Research Network is dynamic data collection that provides insight into patterns of PrEP prescribing and dispensing, patient experience and adherence, longitudinal changes in comorbidities and laboratory values, frequency and time to seroconversion. Continued collection and analyses of patient data will broaden PrEP awareness and optimize patient outcomes.