In-person pick-up versus postal delivery: PrEP service and its association with adherence and retention among Chinese MSM - Paper summary

Q: What delivery models were available to participants during follow-up?

Participants could choose between in-person pick-up and postal delivery of PrEP at each follow-up. The study described initial examination at a hospital and subsequent PrEP provision via mail with health check steps and submission of health reports.

Q: What did the study find about postal PrEP and retention?

Participants using postal PrEP were less likely to be lost to follow-up compared with those using in-person PrEP only. No demographic factors were significantly associated with postal PrEP usage overall.

Sep 27, 2026

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In-person pick-up and postal delivery models of PrEP were compared to understand their association with adherence and retention among Chinese men who have sex with men (MSM). A 12-month PrEP demonstration trial recruited MSM in Wuhan and Guangzhou and collected behavioral outcomes at baseline and quarterly follow-ups. Loss to follow-up and adherence were assessed using generalized linear mixed-effects and logistic regression models adjusting for demographic and behavioral covariates. Results showed that postal PrEP use related to lower loss to follow-up and good adherence was supported by accessibility.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages1

Reading Time3 min

AccessFree to download

Background

Methods

Key definitions & PrEP delivery process

Results

Conclusions

In-person pick-up versus postal delivery: PrEP service and its association with adherence and retention among Chinese MSM \#TUPEE505 Chunyan Li 1,2, Zhuoheng Yin 2 , Quanmin Li 3 , Linghua Li 3 , Songjie Wu 4 , Ke Liang 4 , Gifty Marley 2 , Chengxin Fan 2 , Yifan Dai 2 , Haojie Huang 5 , Aniruddha Hazra 6 , Jonathan Lio 6 , Weiming Tang 2, 7 , Joseph D. Tucker 7,8 , Renslow Sherer 6 Chunyan Li ([chunyanli@alumni. unc.edu](chunyanli@alumni. unc.edu) ); Renslow Sherer ([rsherer@bsd. uchicago.edu](rsherer@bsd. uchicago.edu) ); Joseph D. Tucker ([jdtucker@med. unc.edu](jdtucker@med. unc.edu) ) 1.Tokyo College, the University of Tokyo, Japan 2. UNC-Project China, Guangzhou, China . 3. Guangzhou Eighth People's Hospital, Guangzhou, China 4. Zhongnan Hospital of Wuhan University, Wuhan, China 5. Wuhan Tongxing LGBT Center, Wuhan, China 6. University of Chicago, Chicago, IL, USA 7. University of North Carolina at Chapel Hill, Chapel Hill, NC, USA 8 . London School of Hygiene and Tropical Medicine, London, UK BACKGROUND • Differentiated services are critical for scaling up PrEP in diverse settings . Postal delivery of PrEP could reduce the clinical visit burden for people who are doing well on PrEP and do not require an in-person encounter • In a China-based PrEP demonstration trial, we compared the difference of “in-person pick-up” versus “post-mail delivery” of medications on facilitating PrEP retention and adherence among Chinese MSM. • The sporadic lock-down situations during the trial may have accelerated the adoption of postal PrEP delivery. METHODS • MSM in Wuhan and Guangzhou were recruited by online ads, clinic flyers, and community referrals to a 12-month PrEP demonstration trial. Behavioral data were collected at baseline and quarterly follow-ups over 12 months. • Generalized linear mixed-effects model and logistic regression model were used to assess key outcomes (self-reported good PrEP & loss to follow-up) adjusting for age, sexual orientation, employment status, substance use, condom use, PrEP dosing strategy, and monthly income at baseline . Key definitions & PrEP delivery process in this study • Loss to follow-up (LTF) : Either voluntary withdrawal or not completing the survey within 4 reminders of scheduled follow-up. • Adherence: Self-reported compliance with PrEP dosing schedule in last 30 days (<60% = poor adherence;>= 60% good adherence) of postal used delivery service during the study (excluding 1 pick due 1200 individuals Guangzhou & Wuhan (Community/hospital referral, online advertisement. Peer referral) At each follow-up, participant can choose PrEP delivery model Initial examination & consultation at study hospital PrEP TDF+FTC (Truvada) Prescription (once daily, allow switch to ondemand) In-person pick-up & health check Receive PrEP via mail delivery And/or health check at a local hospital; Submit ecopy of health report RESULTS • By 2023 Sep, 945 MSM (median age=27.2, IQR 24.1-31.4) were enrolled and had time to reach 6-month follow-up. • No sociodemographic characteristics were found significantly associated with postal PrEP usage. • About half of the participants self-reported using event-driven PrEP (M3: 52.4%, M6: 50.8%) . 20.0% LTF before M6 76.7% LTF used only in-person PrEP 23.3% LTF used at least once mail PrEP 0.0% LTF used only postal PrEP Table 1. Main predictors of LTF (n=945, logistic regression model) | Predictors | | LTF % | aOR | 95% C.I . | | --- | --- | --- | --- | --- | | Age | | - | 0.91* | 0.88-0.95 | | PrEP delivery | Ever used postal PrEP | 10.4 | 0.17* | 0.11-0.27 | | | In-person only | 28.0 | ref | | | Monthly Income | <5K RMB/month | 18.5 | 0.55* | 0.31-0.97 | | | >10K RMB/month | 18.3 | ref | | Note: In Tables 1& 2 insignificant covariates omitted. aOR =adjusted odds ratio. CONCLUSIONS 54.4% used only in-person PrEP 19.6% used only postal PrEP 26.0% used both in-person and postal PrEP Table 2. Main

FAQs

How were loss to follow-up and adherence defined in the study?

Loss to follow-up meant voluntary withdrawal or not completing the survey after four reminders. Adherence was self-reported compliance in the last 30 days, with <60% indicating poor adherence and ≥60% indicating good adherence.

What delivery models were available to participants during follow-up?

Participants could choose between in-person pick-up and postal delivery of PrEP at each follow-up. The study described initial examination at a hospital and subsequent PrEP provision via mail with health check steps and submission of health reports.

What did the study find about postal PrEP and retention?

Participants using postal PrEP were less likely to be lost to follow-up compared with those using in-person PrEP only. No demographic factors were significantly associated with postal PrEP usage overall.

Sep 27, 2026

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