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- Pre-exposure Prophylaxis Adherence Among Men Who Have Sex With Men: A Systematic Review and Meta-analysis
- Suchitra Hudrudchai, Charin Suwanwong, Pitchada Prasittichok, Kanu Priya Mohan, Nopphadol Janeaim
- J Prev Med Public Health. 2024;57(1):8-17. Published online December 12, 2023
- DOI: https://doi.org/10.3961/jpmph.23.345
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Abstract
Summary
PDF
Supplementary Material - Objectives
The effectiveness and efficiency of pre-exposure prophylaxis (PrEP) in reducing the transmission of human immunodeficiency virus (HIV) among men who have sex with men (MSM) relies on how widely it is adopted and adhered to, particularly among high-risk groups of MSM. The meta-analysis aimed to collect and analyze existing evidence on various factors related to PrEP adherence in MSM, including demographic characteristics, sexual behaviors, substance use, and psychosocial factors.
Methods
The meta-analysis followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The search included articles published between January 2018 and December 2022, obtained from the PubMed, ScienceDirect, and Scopus databases. The studies that were included in the analysis reported the proportion of MSM who demonstrated adherence to PrEP and underwent quality appraisal using the Newcastle-Ottawa Scale.
Results
Of the 268 studies initially identified, only 12 met the inclusion criteria and were included in the final meta-analysis. The findings indicated that education (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.12 to 2.40), number of sexual partners (OR, 1.16; 95% CI, 1.02 to 1.31), engaging in sexual activities with an human immunodeficiency virus-positive partner (OR, 1.59; 95% CI, 1.16 to 2.26), substance use (OR, 0.83; 95% CI, 0.70 to 0.99), and lower levels of depression (OR, 0.55; 95% CI, 0.37 to 0.82) were associated with higher rates of PrEP adherence among MSM.
Conclusions
Despite these findings, further research is necessary to investigate PrEP adherence more comprehensively. The findings of this meta-analysis can be utilized to inform interventions aimed at improving PrEP adherence among MSM and provide directions for future research in this area. -
SummaryKey Message
This systematic review and meta-analysis confirmed that factors such as education, number of sexual partners, engagement in sexual activities with an HIV-positive partner, substance use, and lower levels of depression were associated with higher rates of PrEP adherence among MSM. Healthcare providers and interventions should take these aspects into consideration when developing strategies to promote optimal PrEP adherence and reduce the risk of HIV transmission.Original Article- Multilevel Analysis of the Relationship Between Prescribing Institutions and Medication Adherence Among Patients With Hypertension and Diabetes in Korea
- Haryeom Ghang, Juhyang Lee
- J Prev Med Public Health. 2023;56(6):504-514. Published online October 5, 2023
- DOI: https://doi.org/10.3961/jpmph.23.252
- 894 View
- 91 Download
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Abstract
Summary
PDFSupplementary Material
- Objectives
This study investigated the relationship between prescribing institutions and medication adherence among patients newly diagnosed with hypertension and diabetes.
Methods
This study investigated patients with new prescriptions for hypertension and diabetes in Korea in 2019 with using data collected from general health screenings. A multilevel logistic regression model was applied to explore the relationship between patients’ first prescribing institution and their medication adherence, defined as a medication possession ratio (MPR) over 80%.
Results
The overall adherence rates were 53.7% and 56.0% among patients with hypertension and diabetes, respectively. The intraclass correlation coefficients were 13.2% for hypertension and 13.8% for diabetes (p<0.001), implying that the first prescribing institution had a significant role in medication adherence. With clinics as the reference group, all other types of hospitals showed an odds ratio (OR) less than 1.00, with the lowest for tertiary hospitals (OR, 0.30 for hypertension; 0.45 for diabetes), and the next lowest in health screening specialized clinics (OR, 0.51 for hypertension; 0.46 for diabetes). Among individual-level variables, female sex, older age, higher insurance premium level, and residing in cities were positively associated with adherence in both the hypertension and diabetes samples.
Conclusions
This study showed that the prescribing institution had a significant relationship with medication adherence. When the first prescribing institution was a clinic, newly diagnosed patients were more likely to adhere to their medication. These results highlight the important role played by primary care institutions in managing mild chronic diseases. -
SummaryKorean summary
2019년 일반건강검진을 통해 발견된 고혈압과 당뇨병의 신규 환자를 대상으로 복약순응도를 분석하였다. 그 결과 검진 후 첫번째 처방기관이 의원인 경우에 비해 다른 종별 의료기관인 경우 복약순응 오즈비가 모두 감소하였는데 상급종합병원이 가장 낮았고(고혈압 0.30, 당뇨병 0.45), 그 다음은 검진전문의원인 것으로 나타났다(고혈압 0.51, 당뇨병 0.46).Key Message
This study investigated the relationship between prescribing institutions and medication adherence among patients newly diagnosed with hypertension and diabetes using general health screening data in Korea in 2019. The results showed that with clinics as the reference group, all other types of hospitals showed an odds ratio (OR) less than 1.00, with the lowest for tertiary hospitals (OR, 0.30 for hypertension; 0.45 for diabetes), and the next lowest in health screening specialized clinics (OR, 0.51 for hypertension; 0.46 for diabetes).
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