Trends of Non-Occupational Post-Exposure Prophylaxis (nPEP) in the United States

Abstract

Objective

To describe national annual rates of non-occupational post-exposure prophylaxis (nPEP) in the United States.

Design

Retrospective cohort study of commercially insured individuals in the Merative MarketScan Database from January 1, 2010 to December 31, 2019.

Methods

Patients ≥13-years prescribed nPEP per recommended Centers for Disease Control and Prevention guidelines were identified using pharmacy claims. Rates of use were described overall and stratified by sex, age group, and region. These rates were qualitatively compared to the diagnosis rates of human immunodeficiency virus (HIV) observed in the data. Joinpoint analysis identified inflection points of nPEP use.

Results

11,397 nPEP users were identified, with a mean age of 33.7 years. Most were males (64.6%) and lived in the south (33.2%) and northeast (32.4%). The rate of nPEP use increased 515%, from 1.42 nPEP users per 100,000 enrollees in 2010 to 8.71 nPEP users per 100,00 enrollees in 2019. The comparative nPEP use rates among subgroups largely mirrored their HIV diagnosis rates, i.e., subgroups with a higher HIV rate had higher nPEP use. In the Joinpoint analysis significant growth was observed from 2012-2015 (estimated annual percentage change [EAPC]: 45.8%; 95% CI: 29.4 – 64.3) followed by a more moderate increase from 2015 – 2019 (EAPC 16.0%; 95% CI: 12.6 – 19.6).

Conclusions

nPEP use increased from 2010 to 2019, but not equally across all risk groups. Further policy interventions should be developed to reduce barriers and ensure adequate access to this important HIV prevention tool.

The full study can be viewed at AIDS.

Mccormick, C. D., Sullivan, P. S., Qato, D. M., Crawford, S. Y., Schumock, G. T., & Lee, T. A. (2023). Trends of non-occupational post-exposure prophylaxis (nPEP) in the United States. AIDS (London, England).