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

Authors:
Sarah Wood
Sarah Wood
The Children's Hospital of Philadelphia
United States
Robert Gross
Robert Gross
Emory University School of Medicine
United States
Judy A Shea
Judy A Shea
University of Pennsylvania
United States
Jose A Bauermeister
Jose A Bauermeister
University of Michigan
United States
Joshua Franklin
Joshua Franklin
Perelman School of Medicine

AIDS Behav 2019 Apr 16. Epub 2019 Apr 16.

Craig A. Dalsimer Division of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA.

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.

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http://link.springer.com/10.1007/s10461-019-02502-y
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http://dx.doi.org/10.1007/s10461-019-02502-yDOI Listing
April 2019
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