AIDS and Behavior

, Volume 18, Issue 2, pp 217–225 | Cite as

Adherence to Post-Exposure Prophylaxis for Non-forcible Sexual Exposure to HIV: A Systematic Review and Meta-Analysis

  • Catherine E. Oldenburg
  • Till Bärnighausen
  • Guy Harling
  • Matthew J. Mimiaga
  • Kenneth H. Mayer
Substantive Review


To characterize adherence to post-exposure prophylaxis after non-forcible sexual exposure to HIV, we conducted a review of the literature and meta-analysis. Articles were considered if they contained primary adherence data following non-forcible sexual exposure. Random-effects meta-analysis was used to create pooled point estimates for adherence. Of 1,257 abstracts identified through our search algorithm, 17 were eligible for inclusion in this review, representing 3,634 patients enrolled in 3 randomized controlled trials (RCTs), 9 prospective and 5 retrospective observational studies. Pooled adherence, primarily assessed by self-report, was 77 % [95 % confidence interval (CI) 68–87] in prospective observational studies, 81 % (95 % CI 65–96) in retrospective studies, 78 % (95 % CI 65–91) in RCTs, and 78 % (95 % CI 72–85) overall. Overall adherence was moderately high, with high variability between studies. Assessment of adherence could be enhanced by the use of objective measurements.


Post-exposure prophylaxis Meta-analysis HIV Medication adherence 


Conflict of interest



CEO is supported by a NIAID T32 NRSA Grant (T32AI007535; PI: Seage).

Supplementary material

10461_2013_567_MOESM1_ESM.docx (37 kb)
Supplementary Table 1 Modified GRADE score assessing quality of included studies (DOCX 37 kb)


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Catherine E. Oldenburg
    • 1
  • Till Bärnighausen
    • 2
  • Guy Harling
    • 3
  • Matthew J. Mimiaga
    • 1
    • 4
    • 5
  • Kenneth H. Mayer
    • 5
    • 6
  1. 1.Department of EpidemiologyHarvard School of Public HealthBostonUSA
  2. 2.Department of Global Health and PopulationHarvard School of Public HealthBostonUSA
  3. 3.Department of Social and Behavioral SciencesHarvard School of Public HealthBostonUSA
  4. 4.Department of PsychiatryHarvard Medical School/Massachusetts General HospitalBostonUSA
  5. 5.The Fenway InstituteFenway HealthBostonUSA
  6. 6.Department of MedicineBeth Israel Deaconess Medical CenterBostonUSA

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