Consistent daily use of pre-exposure prophylaxis, or PrEP, can reduce the risk of HIV infection by 92 percent, but the drug becomes much less effective when taken inconsistently.
Adhering to a daily regimen of any medication can be a challenge, so to assist health care providers in treating patients at risk for contracting HIV, CUNY SPH Professor Christian Grov, DPH student Javier Lopez-Rios, and MPH student Alexa D’Angelo co-led a study into the strategies PrEP users can employ to remember to stay on track with their daily doses. The study was published in the journal Prevention Science.
The researchers conducted one-on-one interviews with 103 gay and bisexual men on PrEP about the factors that contribute to missing a dose and the strategies they use to remember to take it. Participants reported that changes to one’s routine, forgetting, and being away from home were common causes of a lapsed dose. The survey found that nearly all participants in the sample reported using at least one adherence strategy—integrating PrEP into an existing routine such as morning hygiene rituals, using a pillbox, or setting reminders on their phones—to help them remember to take their daily dose.
“Daily PrEP adherence was overall very high in this sample,” says Grov, the study’s lead author. “On average, participants only missed 1.6 doses in the last 30 days. We believe that adherence was high because participants were using these strategies.”
Although PrEP is highly effective even in the event of an occasional missed dose, current FDA guidelines for PrEP recommend it to be taken daily in order to maximize its effectiveness.
“It can be challenging for an otherwise healthy individual to incorporate a new daily pill regimen, and medical providers might consider recommending any number of the strategies we identified for their patients who are either worried about, or struggling with, adherence,” Grov says.
Grov C, Flynn AWP, D’Angelo AB, Lopez-Rios J, Pantalone DW, Holloway, Parsons JT. 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(2019).