TY - JOUR

T1 - Between- and within-individual sociodemographic and psychological determinants of PrEP adherence among men who have sex with men prescribed a daily PrEP regimen in Wales

AU - Gillespie, David

AU - de Bruin, Marijn

AU - Hughes, Dyfrig

AU - Ma, Richard

AU - Williams, Adam

AU - Wood, Fiona

AU - Couzens, Zoë

AU - Jones, Adam T.

AU - Hood, Kerenza

N1 - © 2022. The Author(s).

PY - 2023/5

Y1 - 2023/5

N2 - We investigated the determinants of daily PrEP use and coverage of condomless anal sex (CAS) by PrEP among men who have sex with men in Wales, UK. We measured PrEP use by electronic monitors and CAS by secure online surveys. We defined PrEP use based on daily medication cap openings and coverage as CAS episodes preceded by ≥ 3 days of PrEP use and followed by ≥ 2 days of PrEP use. We included 57 participants (5463 observations). An STI diagnosis was associated with lower PrEP use but also lower PrEP coverage. Older adults had higher PrEP use. A belief that other PrEP users took PrEP as prescribed was associated with lower PrEP coverage. An STI diagnosis is an important cue for an intervention, reflecting episodes of high-risk sexual behaviour and low PrEP coverage. Other results provide a basis for the development of an evidence-informed intervention for promoting coverage of PrEP.

AB - We investigated the determinants of daily PrEP use and coverage of condomless anal sex (CAS) by PrEP among men who have sex with men in Wales, UK. We measured PrEP use by electronic monitors and CAS by secure online surveys. We defined PrEP use based on daily medication cap openings and coverage as CAS episodes preceded by ≥ 3 days of PrEP use and followed by ≥ 2 days of PrEP use. We included 57 participants (5463 observations). An STI diagnosis was associated with lower PrEP use but also lower PrEP coverage. Older adults had higher PrEP use. A belief that other PrEP users took PrEP as prescribed was associated with lower PrEP coverage. An STI diagnosis is an important cue for an intervention, reflecting episodes of high-risk sexual behaviour and low PrEP coverage. Other results provide a basis for the development of an evidence-informed intervention for promoting coverage of PrEP.

KW - Adherence

KW - Determinants

KW - HIV prevention

KW - MSM

KW - Original Paper

KW - PrEP

U2 - 10.1007/s10461-022-03890-4

DO - 10.1007/s10461-022-03890-4

M3 - Article

C2 - 36322216

VL - 27

SP - 1564

EP - 1572

JO - AIDS and Behavior

JF - AIDS and Behavior

SN - 1090-7165

IS - 5

ER -