{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T07:58:09Z","timestamp":1790927889163,"version":"4.1.0"},"reference-count":23,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T00:00:00Z","timestamp":1785024000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T00:00:00Z","timestamp":1785024000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Pre\u2010Exposure Prophylaxis (PrEP) is a cornerstone of HIV prevention, yet its population\u2010level impact is limited by clinical attrition. This study analyses the sociodemographic and behavioural factors associated with follow\u2010up abandonment in a tertiary hospital cohort in Madrid.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study (August 2022\u2013July 2025) was conducted involving 665 participants who initiated oral FTC\/TDF PrEP (of 693 individuals assessed) at Hospital Universitario Ram\u00f3n y Cajal. Abandonment was defined as a &gt;90\u2010day lapse in contact beyond the scheduled visit or medication exhaustion. Independent predictors of discontinuation were identified using Cox proportional hazards regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Follow\u2010up abandonment occurred in 21.2% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009141) (median age: 36.5\u2009years). Three HIV infections were recorded (3\/693; 0.43%), with only one occurring during active use. Multivariate analysis identified younger age as the primary predictor of abandonment, with a 5% risk reduction for every additional year of age (HR 0.95; 95% CI 0.92\u20130.98;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Prior healthcare engagement, evidenced by HBV immunity (anti\u2010HBs+), was significantly protective against attrition (HR 0.52; 95% CI 0.34\u20130.80;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). Transgender women showed a trend towards higher abandonment (HR 3.11,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.060). Notably, contracting a sexually transmitted infection (STI) during follow\u2010up correlated with higher retention, likely due to increased clinical touchpoints and heightened risk perception.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Younger individuals face the highest risk of PrEP discontinuation despite being the demographic most vulnerable to HIV acquisition. Retention is driven more by structural healthcare integration and age than by individual risk behaviours. To improve persistence, healthcare systems must transition towards flexible, digital and decentralized care models tailored to younger, system\u2010na\u00efve users.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hiv.70287","type":"journal-article","created":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T13:26:52Z","timestamp":1785072412000},"page":"1642-1649","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Younger age as a key predictor of follow\u2010up abandonment among\n                    <scp>PrEP<\/scp>\n                    users: A retrospective cohort study in Madrid"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-6950-9006","authenticated-orcid":false,"given":"J.","family":"Mayoral\u2010Alvarez","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases University Hospital Ram\u00f3n y Cajal, IRYCIS  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6441-4141","authenticated-orcid":false,"given":"R.","family":"Fernandez\u2010Ibanez","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases University Hospital Ram\u00f3n y Cajal, IRYCIS  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3880-199X","authenticated-orcid":false,"given":"M.","family":"S\u00e1nchez\u2010Conde","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases University Hospital Ram\u00f3n y Cajal, IRYCIS  Madrid Spain"},{"name":"CIBERINFEC, Instituto de Salud Carlos III  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. M.","family":"Hermida","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases University Hospital Ram\u00f3n y Cajal, IRYCIS  Madrid Spain"},{"name":"CIBERINFEC, Instituto de Salud Carlos III  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9373-6011","authenticated-orcid":false,"given":"M. J.","family":"Vivancos","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases University Hospital Ram\u00f3n y Cajal, IRYCIS  Madrid Spain"},{"name":"CIBERINFEC, Instituto de Salud Carlos III  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3439-8438","authenticated-orcid":false,"given":"R.","family":"Ron","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases University Hospital Ram\u00f3n y Cajal, IRYCIS  Madrid Spain"},{"name":"CIBERINFEC, Instituto de Salud Carlos III  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Mart\u00ednez\u2010Sanz","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases University Hospital Ram\u00f3n y Cajal, IRYCIS  Madrid Spain"},{"name":"CIBERINFEC, Instituto de Salud Carlos III  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5447-3554","authenticated-orcid":false,"given":"S.","family":"Serrano\u2010Villar","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases University Hospital Ram\u00f3n y Cajal, IRYCIS  Madrid Spain"},{"name":"CIBERINFEC, Instituto de Salud Carlos III  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5700-5257","authenticated-orcid":false,"given":"M. J.","family":"Perez\u2010Elias","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases University Hospital Ram\u00f3n y Cajal, IRYCIS  Madrid Spain"},{"name":"CIBERINFEC, Instituto de Salud Carlos III  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2843-1094","authenticated-orcid":false,"given":"Santiago","family":"Moreno","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases University Hospital Ram\u00f3n y Cajal, IRYCIS  Madrid Spain"},{"name":"CIBERINFEC, Instituto de Salud Carlos III  Madrid Spain"},{"name":"Department of Medicine Universidad de Alcal\u00e1  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,26]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"UNAIDS.AIDSinfo database 2022. Accessed December 8 2023.https:\/\/aidsinfo.unaids.org\/"},{"key":"e_1_2_9_3_1","volume-title":"Mortalidad por VIH y sida en Espa\u00f1a. A\u00f1o 2023. Evoluci\u00f3n 1981\u20132023","author":"Centro Nacional de Epidemiolog\u00eda","year":"2025"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.7999"},{"issue":"10","key":"e_1_2_9_5_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0333494","article-title":"Oral pre\u2010exposure prophylaxis retention among men who have sex with men and transgender persons: systematic review and meta\u2010analysis","volume":"20","author":"Court F","year":"2025","journal-title":"PLoS One"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.22692"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa037"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0241340"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2016.10.005"},{"key":"e_1_2_9_10_1","volume-title":"Preexposure Prophylaxis for the Prevention of HIV Infection in the United States\u20142021 Update: A Clinical Practice Guideline","author":"Centers for Disease Control and Prevention, US Public Health Service","year":"2021"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/hiv.13237"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofz101"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.24543"},{"issue":"3","key":"e_1_2_9_14_1","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.eimc.2024.03.014","article-title":"Pre\u2010exposure prophylaxis program in the community of Madrid: two years of experience","volume":"43","author":"Pi\u00f1eiro NF","year":"2025","journal-title":"Enferm Infecc Microbiol Clin (Engl Ed)"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25105"},{"key":"e_1_2_9_16_1","volume-title":"Vigilancia epidemiol\u00f3gica del VIH y sida en Espa\u00f1a: Sistema de Informaci\u00f3n sobre Nuevos Diagn\u00f3sticos de VIH y Registro Nacional de Casos de Sida","author":"Unidad de Vigilancia de VIH, ITS y Hepatitis","year":"2025"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0292289"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(23)00079-6"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000003610"},{"issue":"6","key":"e_1_2_9_20_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0218658","article-title":"Who drops out and when? Predictors of non\u2010response and loss to follow\u2010up in a longitudinal cohort study among STI clinic visitors","volume":"14","author":"Wees DA","year":"2019","journal-title":"PLoS One"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25845"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.26488"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2024.29.48.2400759"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(23)00105-6"}],"container-title":["HIV Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hiv.70287","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/hiv.70287","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hiv.70287","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T07:51:35Z","timestamp":1790927495000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hiv.70287"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,26]]},"references-count":23,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/hiv.70287"],"URL":"https:\/\/doi.org\/10.1111\/hiv.70287","archive":["Portico"],"relation":{},"ISSN":["1464-2662","1468-1293"],"issn-type":[{"value":"1464-2662","type":"print"},{"value":"1468-1293","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,26]]},"assertion":[{"value":"2026-04-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}