{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T22:23:15Z","timestamp":1783117395480,"version":"3.54.6"},"reference-count":49,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>When assessing the effectiveness of pre\u2010exposure prophylaxis (PrEP) programmes, interventions, or modalities, it is important to understand patterns of PrEP use. Continued use of PrEP is frequently referred to as PrEP \u201cpersistence.\u201d But persistence is not defined consistently, and differences impact the interpretation of study outcomes and public health policy. We conducted a scoping review to describe and compare definitions of PrEP persistence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched PubMed, Embase, Scopus and Global Health records (01\/01\/2012\u221201\/26\/2026) for results that discussed longitudinal anti\u2010HIV agents for HIV prevention. We included HIV, prevention and text variations of \u201cpersist\u2010.\u201d We screened abstracts for relevance, reviewed relevant full\u2010text articles, and then extracted key outcomes. Screening and extraction were performed independently by two investigators; conflicts were reviewed and resolved by a third.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our search returned 1549 de\u2010duplicated results. We reviewed 362 full\u2010text articles, yielding 147 studies for extraction. Approximately one\u2010third (42\/147, 29%) provided only qualitative persistence definitions. Among studies with operational definitions (105\/147; 71%), three\u2010quarters (80\/105; 76%) considered a prescription refill and\/or clinic visit date, and more than half (60\/105; 57%) relied exclusively on these dates. Adherence (e.g. reported or measured drug taking) was commonly considered; 28% (29\/105) of studies with an operational persistence definition included adherence assessment, and 11% (12\/105) used only adherence to assess persistence. Thresholds used to classify persistent versus non\u2010persistent PrEP use varied considerably.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Definitions of PrEP persistence are heterogeneous. Most considered engagement in PrEP services (e.g. a clinic visit or medication refill), but nearly one\u2010third included or relied exclusively on adherence measures. The differences in definitions have important implications for cross\u2010study comparisons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The heterogeneity observed among persistence definitions complicates comparisons of PrEP interventions and related public health decision\u2010making. A single consensus definition of persistence is unlikely to suit all study settings, objectives, and designs; however, interpretability and comparability of results could be improved by increasing transparency and consistency in reporting. Our findings emphasize the importance of capturing clinically relevant, prevention\u2010effective use when possible and of rigorously considering the implications of a chosen persistence definition on estimates and associated conclusions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jia2.70115","type":"journal-article","created":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T05:42:28Z","timestamp":1777959748000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Defining HIV Pre\u2010Exposure Prophylaxis (PrEP) Persistence: A Scoping Review"],"prefix":"10.1002","volume":"29","author":[{"given":"Sarah E.","family":"Rutstein","sequence":"first","affiliation":[{"name":"School of Medicine University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace E.","family":"Mulholland","sequence":"additional","affiliation":[{"name":"Gillings School of Global Public Health University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8427-3347","authenticated-orcid":false,"given":"Laura","family":"Limarzi\u2010Klyn","sequence":"additional","affiliation":[{"name":"Gillings School of Global Public Health University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annabelle","family":"Gallinek","sequence":"additional","affiliation":[{"name":"Gillings School of Global Public Health University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2486-2583","authenticated-orcid":false,"given":"Nicole","family":"Brown","sequence":"additional","affiliation":[{"name":"School of Medicine University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William C.","family":"Miller","sequence":"additional","affiliation":[{"name":"Gillings School of Global Public Health University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1108524"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001145"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1011205"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(15)00056\u20102"},{"key":"e_1_2_11_6_1","volume-title":"IN DANGER: UNAIDS Global AIDS Update 2022","author":"Joint United Nations Programme on HIV\/AIDS","year":"2022"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lana.2024.100738"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.3389\/frph.2024.1488970"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.26372"},{"key":"e_1_2_11_10_1","unstructured":"2024 Global AIDS Report \u2014 The Urgency of Now: AIDS at a Crossroads. 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