Preexposure Prophylaxis Prescription Dispensation Status and HIV-1 Acquisition

What is the population-level association between preexposure prophylaxis (PrEP) access and HIV-1 incidence?In this cohort study of 399 902 individuals, HIV-1 incidence was higher among those with rejected or abandoned PrEP claims (3.7% and 2.8%, respectively) who had never had a claim dispensed compared with those with 1 or more claims dispensed (2.0%). Compared with generic oral PrEP, the likelihood of claims being dispensed was lower for all other PrEP regimens, and as cost sharing increased, the likelihood of dispensation decreased.These findings suggest that removing payer-related access barriers to PrEP and improving PrEP claim dispensation may provide opportunities to reduce HIV-1 transmission.

Corresponding Author: Li Tao, PhD, Gilead Sciences Inc, 333 Lakeside Dr, Foster City, CA 94404 (li.tao@gilead.com).

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