PROVIDENCE, R.I. [Brown University School of Public Health] — It has been eight years since the FDA approved PrEP (pre-exposure prophylaxis), a highly effective once daily HIV prevention medication. However, despite marked increases in the medication's use by men who have sex with men (MSM) in the US, this group remains disproportionately impacted by HIV, accounting for 70% of new US infections. In order to understand the factors preventing uptake and adherence to PrEP, many studies have examined the barriers that may impact PrEP adherence among MSM, identifying individual and interpersonal level barriers, as well as structural barriers to adherence. PrEP-related stigma, for example, along with medication side effects and psychosocial factors, have all been associated with non-adherence. These studies, however, combined the perceptions of PrEP-naïve and PrEP-experienced MSM, making it difficult to discern which barriers would be most salient to those already maintaining a PrEP prescription. A new study, by doctoral students in the School of Public Health and colleagues, aimed to close this gap in understanding by conducting an in-depth investigation of the reported perspectives of PrEP-experienced MSM.
The meta-ethnography of PrEP use experiences among cis-gender MSM in the US, published in AIDS Care, found that structural-level interventions, such as telehealth and pharmacist-prescribed approaches to PrEP distribution, may circumvent barriers to uptake and adherence for some MSM, but may not be enough for already underserved communities, such as MSM of color. The study also found that interpersonal-level factors, such as stigma by providers and peers, indicate the need for consideration of social identity in the branding of PrEP for HIV prevention. The study's authors recommend that, in order to be most effective, tailored interventions should consider experienced barriers to PrEP adherence across socioecological levels. Read the complete study.
Study authors: Alberto Edeza, E. Karina Santamaria, Pablo Kokay Valente, Ashley Gomez, Adedotun Ogunbajo, and Katie Biello.