Abstract
Introduction: Pre-exposure prophylaxis (PrEP) offers as much as 90% protection against HIV transmission. However, the effectiveness of PrEP depends on uptake and adherence to even intermittent dosing. Along with intoxication leading to unintentional non-adherence, believing that alcohol mixed with pharmaceuticals is harmful (i.e., interactive toxicity beliefs) may lead to poor uptake and intentional non-adherence.Methods: HIV-negative sexually active men who have sex with men (N = 272) at a large Gay Pride event in Atlanta, GA, completed anonymous surveys of demographic characteristics, sexual behaviour, alcohol use and PrEP-related alcohol interactive toxicity beliefs.Results: A total of 118 (43%) men surveyed had two or more male sex partners and condomless anal sex in the previous six months. Alcohol use was reported by over 90% of men and it was common for participants to believe that mixing alcohol and antiretrovirals is toxic; 75% endorsed at least one interactive toxicity belief. Among the 118 men who had engaged in condomless anal sex and had multiple sex partners, one in three stated that they were not interested in PrEP and men not interested in PrEP were significantly more likely to binge drink and hold interactive toxicity beliefs.Conclusions: These results mirror studies that find interactive toxicity beliefs are a potent predictor of intentional antiretroviral non-adherence among people living with HIV and suggest interactive toxicity beliefs may impede PrEP uptake and adherence. Messages to increase PrEP awareness and adherence may also take steps to counter erroneous beliefs about mixing alcohol with antiretrovirals in the context of PrEP.
Highlights
Pre-exposure prophylaxis (PrEP) offers as much as 90% protection against HIV transmission
The current study focuses on PrEP interactive toxicity beliefs among men who have sex with men (MSM); 67% of US HIV infections occur among MSM and PrEP promotion in the US is most visibly targeted to this population [23]
A total of 118 (43%) men engaged in condomless anal sex and had multiple sex partners, defined here as PrEP candidates
Summary
Pre-exposure prophylaxis (PrEP) offers as much as 90% protection against HIV transmission. Along with intoxication leading to unintentional non-adherence, believing that alcohol mixed with pharmaceuticals is harmful (i.e., interactive toxicity beliefs) may lead to poor uptake and intentional non-adherence. Alcohol use was reported by over 90% of men and it was common for participants to believe that mixing alcohol and antiretrovirals is toxic; 75% endorsed at least one interactive toxicity belief. Conclusions: These results mirror studies that find interactive toxicity beliefs are a potent predictor of intentional antiretroviral non-adherence among people living with HIV and suggest interactive toxicity beliefs may impede PrEP uptake and adherence. Antiretroviral (ARV) medications are at the forefront of HIV prevention, with pre-exposure prophylaxis (PrEP) offering the potential for protection against HIV transmission [1]. ARV was detected in only 9% of infected men, indicating that PrEP resulted in over 90% protection. As PrEP is scaled-up and targeted to populations at greatest risk for HIV infection, increased attention is needed to assure optimal levels of PrEP adherence [6]
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