Table 3.
Determinants of discontinuing PrEP from event-driven and daily PrEP among 365 MSM and 2 TGP participating in the AMPrEP project, Amsterdam, the Netherlands, 2015–2019.
| Univariable HR |
Multivariable |
|||
|---|---|---|---|---|
| Event-driven PrEP → PrEP discontinuation | Daily PrEP → PrEP discontinuation | Event-driven PrEP → PrEP discontinuation | Daily PrEP → PrEP discontinuation | |
| Factorsa | HR (95% CI)f | HR (95% CI)f | aHR (95% CI)f | aHR (95% CI)f |
| Calendar year (per year increase) | 1·16 (0·72–1·87) | 1·21 (0·85–1·71) | ||
| Socio-demographic characteristics | ||||
| Age (per 10 year increase) | 0·80 (0·55–1·16) | 0·64 (0·47–0·86) | 0·97 (0·58–1·64) | 0·62 (0·43–0·89) |
| Non-white ethnicity | 0·95 (0·27–3·37) | 0·73 (0·27–1·96) | ||
| Residency outside Amsterdam | 1·67 (0·71–3·94) | 1·26 (0·68–2·34) | ||
| College/university degree | 0·74 (0·26–2·08) | 0·69 (0·36–1·33) | ||
| Employment | ||||
| Employed | ref. | ref. | ||
| Unemployed | 0·90 (0·20–4·17) | 2·35 (0·70–7·92) | ||
| Other | 0·68 (0·19–2·47) | 1·83 (0·90–3·73) | ||
| Net monthly income >1700€ | 0·90 (0·35–2·34) | 0·62 (0·32–1·21) | ||
| Living with partner/others (vs·alone) | 0·83 (0·35–1·97) | 1·05 (0·58–1·95) | ||
| Not exclusively homosexual | 1·20 (0·42–3·38) | 1·08 (0·52–2·25) | ||
| Sexual behaviour | ||||
| Number of anal sex partnersb,c | 0·57 (0·36–0·89) | 0·71 (0·51–0·99) | ||
| Number of casual sex partnersb,c | 0·54 (0·35–0·83) | 0·70 (0·52–0·95) | 1·24 (0·60–2·57) | 0·35 (0·17–0·71) |
| Having ≥1 HIV-positive sex partnerc | 0·43 (0·17–1·09) | 0·44 (0·23–0·83) | 0·77 (0·16–3·57) | 0·78 (0·34–1·80) |
| Number of anal sex actsb,c | 0·78 (0·53–1·14) | 0·70 (0·52–0·95) | ||
| Number of sex acts with casual sex partnersb,c | 0·48 (0·31–0·74) | 0·74 (0·56–0·98) | ||
| Any CASc | 0·20 (0·08–0·50) | 0·73 (0·20–2·58) | ||
| Number of CAS actsb,c | 0·77 (0·53–1·12) | 0·83 (0·63–1·09) | ||
| Any CAS with casual sex partnersc | 0·10 (0·04–0·25) | 0·69 (0··26–1·85) | ||
| Number of CAS acts with casual partnersb,c | 0·39 (0·23–0·67) | 0·86 (0·66–1·11) | 0·23 (0·05–1·11) | 2·21 (1·19–4·08) |
| Recreational drug use and mental health characteristics | ||||
| Chemsexd | 0·54 (0·18–1·60) | 0·76 (0·36–1·57) | 1·10 (0·22–5·59) | 0·77 (0·34–1·77) |
| Injecting drug usee | – | 1·58 (0·48–5·23) | ||
| Any bacterial STIc | 0·19 (0·02–1·88) | 0·75 (0·37–1·50) | ||
| Chlamydiac | 0·44 (0·05–3·93) | 0·78 (0·32–1·87) | ||
| Gonorrhoeac | – | 0·84 (0·37–1·89) | ||
| Syphilisc | 0·26 (0·00–22·2) | 0·57 (0·08–4·24) | ||
| DUDIT score ≥8 | 0·72 (0·23–2·31) | 1·62 (0·86–3·05) | ||
| AUDIT score ≥8 | 0·20 (0·02–2·10) | 1·65 (0·87–3·16) | ||
| MHI-5 score <60 | 1·56 (0·59–4·17) | 1·59 (0·77–3·27) | ||
| SCS score ≥24 | 0·68 (0·12–3·95) | 1·48 (0·69–3·18) | 0·75 (0·10–5·53) | 1·35 (0·53–3·44) |
| Per extra point on NSSS | 0·98 (0·94–1·02) | 1·00 (0·96–1·03) | 0·99 (0·95–1·04) | 0·95 (0·95–1·03) |
AUDIT: Alcohol Use Disorder Identification Test; CAS: condomless anal sex; Chemsex: use of methamphetamine, γ-hydroxybutyric acid(GHB)/γ-butyrolactone(GBL) and/or mephedrone during sex; DUDIT: Drug Use Disorder Identification Test; HIV: human immunodeficiency virus; MHI-5: 5-item Mental Health Inventory; NSSS: New Sexual Satisfaction Scale; SCS: Sexual Compulsivity Scale; STI: sexually transmitted infection.
All factors except ethnicity, city of residence, education level, employment, net monthly income, living situation and sexual orientation were time-updated.
Per ln increase.
In the past 3 months.
In the past 6 months.
In the past 12 months.
HRs <1 denote that the factor was more likely among those who transitioned versus those who continued their regimen.