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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

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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.

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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).

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Authors and Affiliations

  1. Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, 55 West 125th Street, New York, NY, 10027, USA

    Christian Grov, Alexa B. D’Angelo & Javier Lopez-Rios

  2. CUNY Institute for Implementation Science in Population Health (ISPH), New York, NY, USA

    Christian Grov & Alexa B. D’Angelo

  3. Department of Counseling Psychology, University of Wisconsin Madison, Madison, WI, USA

    Anthony W. P. Flynn

  4. University of Massachusetts Boston, Boston, MA, USA

    David W. Pantalone

  5. Department of Social Welfare, University of California Los Angeles, Los Angeles, CA, USA

    Ian W. Holloway

  6. Hunter College of CUNY, The Center for HIV/AIDS Educational Studies and Training (CHEST), The Graduate Center of CUNY, New York, NY, USA

    Jeffrey T. Parsons

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  1. Christian Grov
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Correspondence to Christian Grov.

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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.

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Grov, C., Flynn, A.W.P., D’Angelo, A.B. et al. Gay and Bisexual Men’s Strategies to Maintain Daily Adherence to Their HIV Pre-exposure Prophylaxis (PrEP) Medication: Results from a Qualitative Study. Prev Sci 20, 168–177 (2019). https://doi.org/10.1007/s11121-019-0985-y

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