855. Persistence on F/TAF versus F/TDF for HIV Pre-Exposure Prophylaxis: A Real-World Evidence Analysis in the United States

Background Persistence to preexposure prophylaxis (PrEP) is an important determinant of its efficacy, but evidence on real-world persistence is lacking. This study assesses adherence to F/TDF and F/TAF for PrEP both in terms of discontinuation and re-initiation patterns. Methods We identified HIV-negative individuals in the United States who initiated F/TDF or F/TAF for PrEP between October 2019 and December 2020 from a de-identified prescription claims database; users taking generic F/TDF were excluded. Non-persistence was defined as a prescription fill gap of >30 days; discontinuation included switch from F/TDF to F/TAF or F/TAF to F/TDF. We used survival analyses to estimate persistence, Cox regressions to compare the hazard ratios (HR) of discontinuation, and logistic regression to compare the odds ratios of re-initiation after discontinuation. Results Among F/TAF users (N=82,402) median age at PrEP initiation was 35 years (interquartile range [IQR] 28−47) and median PrEP persistence was 4 months (IQR 1.8-8.9), compared to 31 years (IQR 25−40) and 2 months (IQR 1.0-3.8) for F/TDF users (N=48,501). PrEP persistence at 60 and 90 days was higher among F/TAF users than F/TDF users (Figure). F/TDF users were 2.5 times more likely to discontinue than F/TAF users, with more marked differences in older users than that in younger users (p for interaction between discontinuation and age group < 0.01, Table). We also observed a higher rate of discontinuation of F/TDF versus F/TAF if PrEP was prescribed by internal medicine or infectious disease physicians than by family medicine physicians (data not shown). After discontinuation, F/TAF users were 1.7 times more likely than F/TDF users to re-initiate PrEP; the association was not different by age. Persistence rates of F/TAF and F/TDF for PrEP by time of PrEP initiation Hazard ratios (HR) and corresponding 95% confidence intervals (CI) of non-persistence and odds ratios (OR) of re-initiation after discontinuation for users of F/TAF and F/TDF for PrEP in the US, Oct 2019 – Dec 2020 Conclusion In this real-world analysis, the F/TAF for PrEP regimen was associated with higher persistence and re-initiation than F/TDF for PrEP. These findings underscore the dynamic nature of PrEP utilization in the real-world and the importance of interventions aimed at improving PrEP persistence and re-initiation in people who would benefit from PrEP. Disclosures Li Tao, MD, PhD, Gilead Sciences Inc (Employee, Shareholder) Valentina Shvachko, MS, Gilead Sciences Inc (Employee, Shareholder) Moupali Das, MD, Gilead Sciences Inc. (Employee, Shareholder) Christoph C. Carter, MD, Gilead Sciences Inc. (Employee, Shareholder) Jared Baeten, MD, PHD, Gilead Sciences Inc. (Employee, Shareholder) David Magnuson, PharmD, Gilead Sciences Inc (Employee, Shareholder)

Joining up well-being and sexual misconduct data and policy in HE: ‘To stand in the gap’ as a feminist approach

This article joins up evidence and policy relating to two linked concerns in higher education (HE) that are treated as unrelated: postgraduate research student (PGR) well-being, and staff sexual misconduct towards students. Against the standard methodology of systematic reviews, we build on feminist approaches to apply a ‘re-performance’ approach to the review. Re-performance re-enacts established methods, contextualising previous analysis through ethnographic and desk-based research, exposing gaps in evidence, analysis, representation, care and policy. We reveal how aspects of PGR experience, particularly the cultures that engender ill-being and enable sexual misconduct, are silenced in evidence-making. Our ‘re-performance’ uncovers how this occurs in three ways, through: the (mis)construction of the ‘typical student’ in well-being literatures; the (mis)construction of the phenomenon of ‘well-being’ exacerbated by generic survey tools focusing on a medicalised model of mental health; the (mis)construction of HE institutions as integrated, agential and ethical, aided by the fragmentation of administrative systems and knowledge production between disciplines. Together, these organising modes conceal lack of care, staff sexual misconduct and poor well-being. From these findings, specific policy issues are identified: the risks to giving more responsibility to supervisors for PGR well-being; a pattern of institutional listening while silencing; and the need to explore feedback loops between patterns of vulnerability to ill-being and staff sexual misconduct. Through our analysis, the article demonstrates how to ‘stand in the gaps’ – between knowledges; and between evidence and action; between policy and care – in a way that can be generalised across policy domains, epistemologies and policy-making contexts.

Behavioural Evidence Analysis

Recent developments in digital forensics (DF) have emphasized that along with inspection of digital evidence, the study of behavioural clues based on behavioural evidence analysis (BEA) is vital for accurate and complete criminal investigation. This paper reviews the existing BEA approaches and process models and concludes the lack of standardisation in the BEA process. The research comprehends that existing BEA methodologies are restricted to specific characteristics of the forensic domain in question. To address these limitations, the paper proposes a standardised approach detailing the step-by-step implementation of BEA in the DF process. The proposed model presents a homogenous technique that can be practically applied to real-life cases. This standard BEA framework classifies digital evidence into categories to decipher associated offender characteristics. Unlike existing models, this new approach collects evidence from diverse sources and leaves no aspect unattended while probing criminal behavioural cues, thus facilitating its applicability across varied forensic domains.

Kepemimpinan Kepala Sekolah dalam Peningkatan Mutu Pendidikan : Studi Kasus di SMK Nurul Jadid

The research is focused on the leadership of principals in improving the service and quality of NJ Vocational High Schools, with research questions directed at: What is the function and principals manner management in upgrading school quality and service in NJ Vocational Schools? What is the reality of quality and educational services currently at NJ Vocational School? To express questions, the method used by researchers is a qualitative method, by focus evidence analysis. To extract information and data from the informant (informant), the researcher used document analysis techniques, observation, and then ended with an interview to confirm the data. The results reveal that; Principal's leadership style in improving service and education quality in SMK Nurul Jadid Paiton Probolinggo is a team or democratic management style. Whereas the leadership function that is applied is in line with the concept of leadership which is widely raised by expert observers. The reality of schools quality in SMK Nurul Jadid Paiton Probolinggo, such as, raw inputs develop rapidly, the instrumental quality of inputs is incomplete but effective, and the environmental quality in the educational institutions is harmony.

Mapping Participatory Methods in the Urban Development Process: A Systematic Review and Case-Based Evidence Analysis

Despite the fact that vulnerable communities are the most affected by unplanned cities, considerably less attention has been given to involving them in urban development in order to ensure equitable outcomes. In this regard, there is an urgent need for governments to introduce and enforce processes that allow citizens, including vulnerable communities, to participate in development planning and policymaking. However, at present, there is a lack of guidance for practitioners regarding the definition of a clear purpose of community engagement and the selection of appropriate participatory methods to fulfil the set purpose. This study provides a thorough account of the participatory methods that can be used to achieve various engagement goals throughout the urban development process. This structured literature review used 71 reports published from 2000 to 2020. The review revealed 34 participatory methods, wherein most of the methods are devoted to informing, consulting and involving communities, whilst only a few methods are available for interactive public participation that supports true collaboration and empowerment. The study identified 12 purposes of community engagement in urban development, and mapped the 34 participatory methods for achieving them. The analysed case studies showed that the current community engagement practices are mainly in the pre-design and briefing stages of the urban development processes, and that most projects are aiming to achieve the ‘inform’ and ‘consult’ levels of engagement, with a few aiming to achieve the ‘involve’ and ‘collaborate’ levels. This study shows that community engagement is often overlooked during the professional design, development and post-development phases. The paper presents an onion model which can be used by practitioners to choose appropriate participatory methods based on the intended urban development phase, the engagement level and the purpose of the community engagement.