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Gay and Bisexual Men’s Strategies to Maintain Daily Adherence to Their HIV Pre-exposure Prophylaxis (PrEP) Medication: Results from a Qualitative Study

  • Christian Grov
  • Anthony W. P. Flynn
  • Alexa B. D’Angelo
  • Javier Lopez-Rios
  • David W. Pantalone
  • Ian W. Holloway
  • Jeffrey T. Parsons
Article
  • 15 Downloads

Abstract

Since FDA approval in 2012, HIV pre-exposure prophylaxis (PrEP) has been adopted by key populations, including gay and bisexual men (GBM), to reduce their HIV transmission risk. Given that PrEP is optimally effective when taken as prescribed, it is critical to understand the adherence strategies GBM use. We conducted one-on-one, semi-structured interviews with GBM taking PrEP in 2015–2016 (n = 103). Using thematic analysis, we identified six adherence strategies, with most participants (84.3%) utilizing multiple strategies to maintain adequate adherence: (1) integrating PrEP into part of a daily routine, (2) using a pillbox, (3) cognitive strategies/visual cues, (4) setting recurring smartphone alarms or reminders, (5) keeping medication on oneself at all times, and (6) partner or peer support for reminders and/or pill sharing. Overall, participants reported high PrEP adherence (M = 1.6 missed doses in the prior 30 days), though nearly all described missing at least one dose unintentionally in the past. Participants credited their high levels of adherence in part to the strategies they adopted. Providers working with GBM prescribed PrEP, especially patients reporting difficulties with adherence, might consider recommending any or all of the six strategies described in this study.

Keywords

Pre-exposure prophylaxis (PrEP) Adherence Gay and bisexual men HIV Qualitative data 

Notes

Acknowledgments

The authors would like to acknowledge the contributions of other members of the PrEP & Me study team (Mark Pawson, Demetria Cain, Brian Salfas, Chloe Mirzayi, Juan Castiblanco, and Ruben Jimenez), and other staff from the Center for HIV/AIDS Educational Studies and Training (Chris Hietikko, Tina Koo, Desmond Dutcher, and Carlos Ponton). Finally, we thank Shoshana Kahana at NIDA and all of our participants who participated in PrEP & Me.

Funding

PrEP & Me was funded by the National Institute of Drug Abuse (R21- DA039019, PI: Grov).

Compliance with Ethical Standards

Conflicts of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Disclaimer

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health (NIH). NIDA/NIH had no role in the production of this manuscript nor necessarily endorses its findings.

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Copyright information

© Society for Prevention Research 2019

Authors and Affiliations

  • Christian Grov
    • 1
    • 2
  • Anthony W. P. Flynn
    • 3
  • Alexa B. D’Angelo
    • 1
    • 2
  • Javier Lopez-Rios
    • 1
  • David W. Pantalone
    • 4
  • Ian W. Holloway
    • 5
  • Jeffrey T. Parsons
    • 6
  1. 1.Department of Community Health and Social SciencesCUNY Graduate School of Public Health and Health PolicyNew YorkUSA
  2. 2.CUNY Institute for Implementation Science in Population Health (ISPH)New YorkUSA
  3. 3.Department of Counseling PsychologyUniversity of Wisconsin MadisonMadisonUSA
  4. 4.University of Massachusetts BostonBostonUSA
  5. 5.Department of Social WelfareUniversity of California Los AngelesLos AngelesUSA
  6. 6.Hunter College of CUNY, The Center for HIV/AIDS Educational Studies and Training (CHEST)The Graduate Center of CUNYNew YorkUSA

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