Abstract
BackgroundTo investigate the associations between the perceived barriers and benefits of using HIV pre-exposure prophylaxis medication, including worries about the side effects, disliking taking drugs, perceived burden of taking medication, positive expectations as to the efficacy of the drugs, favourable doctor-patient relationships, and medication adherence among men who have sex with men (MSM) to provide a target for improving medication adherence and reducing HIV infection among MSM.MethodsMSM were recruited in western China from April 2013 to October 2014, administered oral tenofovir (TDF) daily and followed up every 12 weeks for 2 years. At each follow-up, the medication rate was calculated based on the self-reported number of missed doses over 2 weeks, and then, the medication adherence was evaluated. The barriers and benefits perceived during medication were obtained by a self-administered questionnaire, and their effects on medication adherence were analysed by linear mixed models.ResultsA total of 411 participants were enrolled in this study, and 1561 follow-up observation points were obtained. The average medication rate was 0.62 ± 0.37, and the medication rate increased with longer follow-up (P < 0.05). The medication rate was higher among MSM who were divorced (compared to those who were unmarried, P < 0.0001). MSM with more positive expectations as to the efficacy of the drugs showed higher rates of medication (P < 0.0001), while those who were more worried about side effects had a lower medication rate (P = 0.0208). In contrast, the dislike of taking the drugs and the burden perceived during medication had no effects on the actual medication rate of taking TDF (P > 0.05).ConclusionHow to obtain and maintain high medication adherence among MSM is the key to the PrEP intervention strategy for effective reduction of HIV infection. For MSM in China, we should deepen their understanding of the effectiveness and safety of PrEP and increase their confidence in PrEP, thereby improving their medication adherence.Trial registrationChiCTR-TRC-13003849. Registered on 24/06/2013.
Highlights
To investigate the associations between the perceived barriers and benefits of using HIV preexposure prophylaxis medication, including worries about the side effects, disliking taking drugs, perceived burden of taking medication, positive expectations as to the efficacy of the drugs, favourable doctor-patient relationships, and medication adherence among men who have sex with men (MSM) to provide a target for improving medication adherence and reducing HIV infection among MSM
In this study, we aimed to investigate the changes in barriers and benefits that HIV-uninfected MSM perceive during the course of medication and examine the associations between perceived barriers and benefits of oral Pre-exposure prophylaxis (PrEP) and actual medication adherence to provide a basis and some guidance for application and promotion of PrEP strategies among MSM in China
This study is among the first to examine the potential factors related to PrEP adherence among MSM in a clinical trial in China, and its findings suggest that MSM’s positive expectations towards medication was a facilitator, while their worries about drug side effects was a barrier to PrEP adherence during the whole course of medication
Summary
To investigate the associations between the perceived barriers and benefits of using HIV preexposure prophylaxis medication, including worries about the side effects, disliking taking drugs, perceived burden of taking medication, positive expectations as to the efficacy of the drugs, favourable doctor-patient relationships, and medication adherence among men who have sex with men (MSM) to provide a target for improving medication adherence and reducing HIV infection among MSM. The report of the Joint United Nations Program on HIV/ AIDS [1] points out that the number of HIV infections reached 1.8 million in 2016 and men who have sex with men (MSM) have a higher risk of infection. The Progress Report on AIDS Prevention and Treatment in China [2] shows that the HIV epidemic currently maintains a lowprevalence trend, with a higher-prevalence among MSM, especially in the western part of China [3]. Many international clinical studies have shown the effectiveness of PrEP in different groups, including MSM [8,9,10], women [11] and injection drug users [12, 13]
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