Barriers and Facilitators of PrEP Adherence for Young Men and Transgender Women of Color.

TitleBarriers and Facilitators of PrEP Adherence for Young Men and Transgender Women of Color.
Publication TypeJournal Article
Year of Publication2019
AuthorsWood S, Gross R, Shea JA, Bauermeister JA, Franklin J, Petsis D, Swyryn M, Lalley-Chareczko L, Koenig HC, Dowshen N
JournalAIDS Behav
Date Published2019 Apr 16
ISSN1573-3254
Abstract

We aimed to discover barriers and facilitators of HIV pre-exposure prophylaxis (PrEP) adherence in young men and transgender women of color who have sex with men (YMSM/TW). Short-term and sustained adherence were measured by urine tenofovir concentration and pharmacy refills, respectively. Optimal adherence was defined as having both urine tenofovir concentration consistent with dose ingestion within 48 h and pharmacy refills consistent with ≥ 4 doses per week use. Participants completed semi-structured interviews exploring adherence barriers and facilitators. Participants (n = 31) were primarily African-American (68%), mean age 22 years (SD: 1.8), and 48% had optimal adherence. Adherence barriers included stigma, health systems inaccessibility, side effects, competing stressors, and low HIV risk perception. Facilitators included social support, health system accessibility, reminders/routines, high HIV risk perception, and personal agency. Our findings identify targets for intervention to improve PrEP adherence in these populations, including augmenting health activation and improving accuracy of HIV risk perception.

DOI10.1007/s10461-019-02502-y
Alternate JournalAIDS Behav
PubMed ID30993479
Grant ListNIMH F32 MH111341 / / National Institute of Mental Health /
NIMH K23MH102128 / / National Institute of Mental Health /
P30 AI 045008 / / Center for AIDS Research University of Pennsylvania /
P30 MH 097488 / / Penn Mental Health AIDS Research Center /