Article Impact Level: HIGH Data Quality: STRONG Summary of Journal of General Internal Medicine. https://doi.org/10.1007/s11606-025-09574-8 Dr. Nina E. Hill et al.
Points
- From 2016 to 2023, PrEP dispensing among U.S. adults aged 18 to 25 rose significantly, reaching 208.4 prescriptions per 100,000 individuals by 2023.
- Although initiation rates improved, average PrEP persistence declined from 111.6 days to 98.4 days, indicating reduced consistency in use over time.
- Young adults aged 18 to 21 consistently showed lower dispensing and initiation rates than those aged 22 to 25, highlighting an age-related disparity.
- The study emphasizes that increasing access to PrEP is not enough without addressing adherence and continuation challenges, particularly in the youngest age group.
- Targeted public health strategies and stronger provider support are essential to improve long-term PrEP use and ensure effective HIV prevention in young adults.
Summary
This study aimed to assess trends in pre-exposure prophylaxis (PrEP) dispensing among young adults aged 18–25 years in the U.S. from 2016 to 2023, focusing on the impact of PrEP on HIV prevention. The study, which utilized data from the IQVIA Longitudinal Prescription Database, revealed that PrEP dispensing rates increased significantly during the study period. By 2023, the dispensing rate reached 208.4 prescriptions per 100,000 young adults, up from 26.4 per 100,000 in 2016, representing a 12.5% quarterly increase (95% CI: 10.0%–15.1%) from 2016 to 2018, and a more gradual 3.5% (95% CI: 2.7%–4.3%) increase thereafter. The initiation rates followed similar trends, indicating greater adoption of PrEP among young adults.
However, while dispensing rates and initiation increased, PrEP persistence—a key measure of consistent use—declined over the study period. The quarterly mean persistence decreased from 111.6 days to 98.4 days (QPC: −0.4%, 95% CI: −0.6 to −0.2), suggesting that while more young adults are starting PrEP, fewer are continuing treatment consistently. Additionally, a disparity in PrEP dispensing and initiation was noted between younger individuals (18–21 years) and older individuals (22–25 years), with those aged 18–21 years having lower dispensing and initiation rates throughout the study period.
The findings of this study underscore the increasing use of PrEP among young adults but highlight concerns regarding the consistency of use. The study suggests that while progress has been made in increasing PrEP access, efforts are needed to address challenges in long-term adherence. These results point to the importance of targeted interventions to improve PrEP persistence, especially among younger individuals at risk of HIV. Continued public health initiatives and healthcare provider engagement are crucial to ensuring that these patients maintain adherence and benefit from the preventive effects of PrEP.
Link to the article: https://link.springer.com/article/10.1007/s11606-025-09574-8
References Hill, N. E., He, S., & Chua, K.-P. (2025). National trends in hiv pre-exposure prophylaxis dispensing to young adults, 2016–2023. Journal of General Internal Medicine. https://doi.org/10.1007/s11606-025-09574-8
