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Adherence was measured using the proportion of days covered (PDC) over 180\u00a0days and categorized by clinically relevant thresholds (\u2265\u200985%,\u2009\u2265\u200980%,\u2009\u2265\u200957%). Continuation was assessed based on uninterrupted PrEP supply without a\u2009\u2265\u200930-day gap. Statistical analyses included propensity-score matching and regression modeling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Results<\/jats:title>\n                    <jats:p>\n                      Among 43,913 eligible individuals, 1,245 (2.84%) had an AUD diagnosis prior to PrEP initiation. In a matched sample of 1,153 individuals, those with AUD had lower mean PDC (59.54% [34.14] vs. 65.85% [33.18];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and fewer mean days of continuous PrEP use (107 [67.20] days vs. 119.90 [65.21] days;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) compared to the Without AUD group. Regression analyses showed individuals with AUD had 6.31% lower mean PDC (95% CI: -9.05% to -3.57%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and 12.93 fewer days of PrEP continuity (95% CI: -18.34 to -7.52\u00a0days;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) compared to the Without AUD group. Findings may not be generalizable beyond commercially insured individuals, and we may have not captured all factors that influence PrEP adherence.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Individuals with AUD before PrEP initiation exhibited lower adherence and continuation compared to those without AUD. Targeted interventions may be required to enhance PrEP adherence and continuity in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11606-025-10114-7","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T15:58:40Z","timestamp":1769529520000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Alcohol Use Disorder Diagnoses and HIV Preexposure Prophylaxis Adherence and Continuation: a Retrospective Cohort Study"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4903-870X","authenticated-orcid":false,"given":"Anton L. 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