Open AccessBarriers and Facilitators of PrEP Adherence for Young Men and Transgender Women of Color
Author(s) -
Sarah Wood,
Robert Gross,
Judy A. Shea,
José A. Bauermeister,
Joshua Franklin,
Danielle Petsis,
Meghan Swyryn,
Linden LalleyChareczko,
Helen Koenig,
Nadia Dowshen
Publication year - 2019
Publication title -
aids and behavior
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.994
H-Index - 106
eISSN - 1573-3254
pISSN - 1090-7165
DOI - 10.1007/s10461-019-02502-y
Subject(s) - transgender women , transgender , medicine , health psychology , public health , men who have sex with men , social stigma , social support , intervention (counseling) , family medicine , human immunodeficiency virus (hiv) , pre exposure prophylaxis , pharmacy , clinical psychology , psychology , nursing , syphilis , social psychology , psychoanalysis
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.