מילות מפתח: PREP; MSM; HIV

רקע מדעי ומטרה:

PrEP is an effective HIV prevention strategy for individuals at increased risk. In Israel, PrEP is mainly prescribed in outpatient primary care settings, with routine follow-up visits that include vaccination adherence. This study aims to assess vaccine uptake, characterize the vaccinated population, and identify factors influencing vaccination in this high-risk group.

שיטות:

This retrospective cohort study was conducted in a large outpatient setting. Patients who purchased FTC/TDF for PrEP at least once during the study period were included. Data on vaccinations, PrEP adherence, socioeconomic status, STI diagnoses, and prescribing physicians were extracted from electronic medical records. Vaccine adherence was assessed for hepatitis A, B, monkeypox, Human papillomavirus (HPV), and influenza, with complete vaccination defined according to national guidelines. Descriptive and multivariable analyses were performed to identify factors associated with vaccine uptake.

תוצאות:

During 2023, 2668 patients purchased at least one PrEP prescription. Their median age was 36 years (range 18-86 years), and all were male. Among them, 1624 (60.9%) were fully vaccinated for hepatitis A, 1512 (58.2%) for hepatitis B, 598 (22.4%) for monkeypox, and 595 (27.7%) for HPV. The most significant predictor for vaccination against hepatitis A, B, and monkeypox was adherence to PrEP (OR=1.97, 95% CI = 1.57-2.57, p<0.001). A similar association was observed for the HPV vaccine (OR=1.68, 95% CI = 1.37-2.06, p<0.001).

מסקנות:

Adherence to recommended vaccines was suboptimal among PrEP patients. The strongest associations with vaccine adherence were high PrEP adherence and prescriptions by family physicians. Targeted interventions to enhance vaccination uptake within PrEP care settings are warranted.

חשיבות לרפואת המשפחה: