Background Uptake of HIV pre-exposure prophylaxis (PrEP) has been increasing in the United States since its FDA approval in 2012; however, the COVID-19 pandemic may have affected this trend. Our objective was to assess the impact of COVID-19 on PrEP prescriptions in the United States. Methods We analyzed data from a national pharmacy database from January 2017 through March 2021 to fit an interrupted time-series model that predicted PrEP prescriptions and new PrEP users had the pandemic not occurred. Observed PrEP prescriptions and new users were compared with those predicted by the model. Main outcomes were weekly numbers of PrEP prescriptions and new PrEP users based on a previously developed algorithm. The impact of the COVID-19 pandemic was quantified by computing rate ratios and percentage decreases between the observed and predicted counts during 15/3/2020–31/3/2021. Results In the absence of the pandemic, our model predicted that there would have been 1 058 162 PrEP prescriptions during 15/3/2020–31/3/2021. We observed 825 239 PrEP prescriptions, a 22.0% reduction (95% CI: 19.1–24.8%) after the emergency declaration. The model predicted 167 720 new PrEP users during the same period; we observed 125 793 new PrEP users, a 25.0% reduction (95% CI: 20.9–28.9%). The COVID-19 impact was greater among younger persons and those with commercial insurance. The impact of the pandemic varied markedly across states. Conclusions The COVID-19 pandemic disrupted an increasing trend in PrEP prescriptions in the United States, highlighting the need for innovative interventions to maintain access to HIV-prevention services during similar emergencies.

中文翻译：

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2019 年冠状病毒病 (COVID-19) 对美国人类免疫缺陷病毒 (HIV) 暴露前预防处方的影响——时间序列分析

背景 自 2012 年获得 FDA 批准以来，美国对 HIV 暴露前预防 (PrEP) 的采用一直在增加；然而，COVID-19 大流行可能影响了这一趋势。我们的目标是评估 COVID-19 对美国 PrEP 处方的影响。方法 我们分析了 2017 年 1 月至 2021 年 3 月国家药房数据库中的数据，以拟合一个中断的时间序列模型，该模型预测 PrEP 处方和新 PrEP 用户没有发生大流行。将观察到的 PrEP 处方和新用户与模型预测的进行比较。主要成果是基于先前开发的算法的每周 PrEP 处方和新 PrEP 用户数量。COVID-19 大流行的影响是通过计算速率比率以及在 15/3/2020 至 31/3/2021 期间观察到的计数和预测计数之间的百分比下降来量化的。结果 在没有大流行的情况下，我们的模型预测在 2020 年 3 月 15 日至 2021 年 3 月 31 日期间会有 1 058 162 份 PrEP 处方。我们观察了 825 239 份 PrEP 处方，在宣布紧急状态后减少了 22.0%（95% CI：19.1–24.8%）。该模型预测同期有 167 720 名新 PrEP 用户；我们观察到 125 793 名新的 PrEP 用户，减少了 25.0%（95% CI：20.9–28.9%）。COVID-19 对年轻人和有商业保险的人的影响更大。大流行的影响在各州之间存在显着差异。结论 COVID-19 大流行扰乱了美国 PrEP 处方的增长趋势，