PrEP Adherence, Persistence Among MSM in Southern United States

Self-reported overall use of pre-exposure prophylaxis (PrEP) was high in a cohort of men who have sex with men (MSM), but specific times of nonadherence frequently overlapped with sexual activity. Researchers published their findings in AIDS and Behavior.

“This indicates that potential human immunodeficiency virus (HIV) exposure might be common among MSM who have discontinued PrEP or who are nonadherent to the dosing regimen,” wrote a research team from Emory University.

The study included 78 MSM from the southern United States recruited via online advertisements. Researchers were interested in the feasibility of using short, frequent surveys to determine alignment between PrEP use and sexual behavior and conducted the study mainly to test the process. Participants completed a survey at baseline and then brief surveys every 2 weeks over a 4-month period.

Retention in the study was high, researchers reported. Baseline and final surveys were completed by 91% of participants, and 86% of all surveys were completed, leading investigators to determine the process was feasible and acceptable.

Regarding the PrEP adherence, 89% of participants reported continuing to take PrEP at the final survey. Most participants reported complete adherence or adherence sufficient to provide protection against HIV transmission.

“Although nonadherence and discontinuation were not common,” researchers pointed out, “having an episode of condomless anal sex during a period of nonadherence or discontinuation was very common.”

The most frequently reported reasons for skipping a PrEP dose were being too busy, not having the medication on hand, and not being sexually active, the study found.

“These findings indicate that increased efforts will be necessary to ensure that once MSM initiate PrEP, they continue to use it as prescribed as long as it is indicated based on behavioral risk,” researchers advised.

Reference:
Jones J, Pampati S, Siegler AJ. Alignment of PrEP use and sexual behavior over four months among men who have sex with men in the southern United States. AIDS Behav. 2022 Apr 16;1-8. doi:10.1007/s10461-022-03685-7