{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T23:08:05Z","timestamp":1789168085954,"version":"build-2803163510"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T00:00:00Z","timestamp":1747008000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>HIV continues to be a public health concern and pre-exposure prophylaxis (PrEP) has become an important HIV prevention strategy. We examined PrEP persistence over time in two health facilities in Gauteng, South Africa.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective analysis of PrEP persistence between 2018 and 2022 in two government health facilities in Gauteng. Data was manually extracted from the patient medical records and captured into REDCap. We defined PrEP persistence as PrEP use over time from the date of PrEP initiation without an interruption of more than 30\u202fdays between prescription refills. We used Kaplan\u2013Meier survival curves to illustrate time to PrEP discontinuation. We used Cox proportional hazard models to examine factors associated with PrEP discontinuation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 344 patients were included in the analysis of which 48.2% were &amp;gt;24\u202fyears and 68.0% were females. PrEP persistence was 65.7% at month 1, 45.9% at month 2 and 37.8% at month 3 with a median persistence time of 76\u202fdays. Individuals &amp;gt;24\u202fyears were less likely to discontinue PrEP (aHR\u202f=\u202f0.55, 95%CI: 0.39\u20130.77) compared to those 15\u201319-years. PrEP discontinuation was more likely in Facility A than in Facility B (aHR\u202f=\u202f2.96, 95%CI: 2.10\u20134.17).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We have shown that most people stop taking PrEP before their second PrEP refill and individuals &amp;gt;24\u202fyears had longer PrEP persistence than individuals aged 15\u201319\u202fyears. Service delivery factors appear to have a substantial effect on PrEP persistence. Health facilities should continue to make PrEP accessible by integrating PrEP with existing services to promote PrEP persistence.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2025.1460180","type":"journal-article","created":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T05:40:07Z","timestamp":1747028407000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Pre-exposure prophylaxis persistence at two sites in an integrated primary health care programme in South Africa"],"prefix":"10.3389","volume":"13","author":[{"given":"Nosipho","family":"Shangase","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anele","family":"Jiyane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fezile","family":"Buthelezi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cara","family":"O\u2019Connor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"Brown","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Rees","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,12]]},"reference":[{"key":"ref1","year":"2023"},{"key":"ref2","year":"2022"},{"key":"ref3","year":"2022"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e25872","DOI":"10.1002\/jia2.25872","article-title":"HIV prevention: better choice for better coverage","volume":"25","author":"Bekker","year":"2022","journal-title":"J Int AIDS Soc"},{"key":"ref5","year":"2015"},{"key":"ref6","article-title":"PrEP implementation pack","volume-title":"South African Department of Health: South Africa 2016\u20132017","year":"2017"},{"key":"ref7","volume-title":"Technical brief: Preventing HIV during pregnancy and breastfeeding in the context of PrEP [internet]","year":"2017"},{"key":"ref8","first-page":"1","year":"2020"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"S15","DOI":"10.1097\/QAD.0000000000003103","article-title":"From policy to practice: uptake of pre-exposure prophylaxis among adolescent girls and young women in United States President\u2019s emergency plan for AIDS relief-supported countries, 2017\u20132020","volume":"36","author":"Patel","year":"2022","journal-title":"AIDS"},{"key":"ref10","year":""},{"key":"ref11","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)\u2014a metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"Harris","year":"2009","journal-title":"J Biomed Inform"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1093\/cid\/ciaa037","article-title":"Persistence with human immunodeficiency virus pre-exposure prophylaxis in the United States, 2012\u20132017","volume":"72","author":"Huang","year":"2021","journal-title":"Clin Infect Dis"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"564","DOI":"10.1007\/s10461-023-04246-2","article-title":"Understanding Oral PrEP interest, uptake, persistence, and experience of use among heterosexual men in Johannesburg, South Africa: an exploratory pilot study","volume":"28","author":"Felker-Kantor","year":"2024","journal-title":"AIDS Behav"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"e1004088","DOI":"10.1371\/journal.pmed.1004088","article-title":"High PrEP uptake and objective longitudinal adherence among HIV-exposed women with personal or partner plans for pregnancy in rural Uganda: a cohort study","volume":"20","author":"Matthews","year":"2023","journal-title":"PLoS Med"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"2623","DOI":"10.1007\/s10461-022-03592-x","article-title":"Daily Oral pre-exposure prophylaxis (PrEP) continuation among women from Durban, South Africa, who initiated PrEP as standard of care for HIV prevention in a clinical trial","volume":"26","author":"Beesham","year":"2022","journal-title":"AIDS Behav"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1112","DOI":"10.1007\/s10461-020-03072-0","article-title":"Exploring the use of Oral pre-exposure prophylaxis (PrEP) among women from Durban, South Africa as part of the HIV prevention package in a clinical trial","volume":"25","author":"Beesham","year":"2021","journal-title":"AIDS Behav"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"e17716","DOI":"10.1097\/MD.0000000000017716","article-title":"Low awareness and use of pre-exposure prophylaxis among adolescents and young adults in high HIV and sexual violence prevalence settings","volume":"98","author":"Ajayi","year":"2019","journal-title":"Medicine"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"888","DOI":"10.1186\/s12913-021-06920-4","article-title":"A community-based mobile clinic model delivering PrEP for HIV prevention to adolescent girls and young women in Cape Town, South Africa","volume":"21","author":"Rousseau","year":"2021","journal-title":"BMC Health Serv Res"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1391","DOI":"10.1097\/QAD.0000000000002221","article-title":"Modelling the potential impact of providing preexposure prophylaxis in pregnant and breastfeeding women in South Africa","volume":"33","author":"Joseph Davey","year":"2019","journal-title":"AIDS"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"e25866","DOI":"10.1002\/jia2.25866","article-title":"Early pre-exposure prophylaxis (PrEP) initiation and continuation among pregnant and postpartum women in antenatal care in Cape Town, South Africa","volume":"25","author":"Joseph Davey","year":"2022","journal-title":"J Int AIDS Soc"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1303","DOI":"10.7196\/SAMJ.2023.v113i8.1191","article-title":"Urgent appeal to allow all professional nurses and midwives to prescribe pre-exposure prophylaxis (PrEP) in South Africa","volume":"113","author":"Davey","year":"2023","journal-title":"S Afr Med J"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"796","DOI":"10.1097\/OLQ.0000000000001871","article-title":"Prevalence of curable sexually transmitted infections in a population-representative sample of young adults in a high HIV incidence area in South Africa","volume":"50","author":"Jarolimova","year":"2023","journal-title":"Sex Transm Dis"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1371\/journal.pone.0294285","article-title":"Prevalence and incidence of sexually transmitted infections among south African women initiating injectable and long-acting contraceptives","volume":"18","author":"Harryparsad","year":"2023","journal-title":"PLoS One"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1","DOI":"10.4102\/sajhivmed.v23i1.1465","article-title":"Erratum: southern African HIV clinicians society 2022 guideline for the management of sexually transmitted infections: moving towards best practice","volume":"23","author":"Peters","year":"2022","journal-title":"South Afr J HIV Med"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"3978","DOI":"10.1007\/s10461-021-03320-x","article-title":"\u201cI had made the decision, and no one was going to stop me\u201d \u2014facilitators of PrEP adherence during pregnancy and postpartum in Cape Town, South Africa","volume":"25","author":"Joseph Davey","year":"2021","journal-title":"AIDS Behav"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"e0228620","DOI":"10.1371\/journal.pone.0228620","article-title":"Factors influencing uptake, continuation, and discontinuation of oral PrEP among clients at sex worker and MSM facilities in South Africa","volume":"15","author":"Pillay","year":"2020","journal-title":"PLoS One"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1729","DOI":"10.1007\/s10508-020-01880-y","article-title":"Exploring perceived barriers and facilitators of PrEP uptake among young people in Uganda, Zimbabwe, and South Africa","volume":"50","author":"Muhumuza","year":"2021","journal-title":"Arch Sex Behav"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1460180\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T05:40:08Z","timestamp":1747028408000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1460180\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,12]]},"references-count":27,"alternative-id":["10.3389\/fpubh.2025.1460180"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2025.1460180","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,12]]},"article-number":"1460180"}}