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Facilitators and barriers affecting PrEP adherence among Thai men who have sex with men (MSM) in the HPTN 067/ADAPT Study.

Authors
  • Chemnasiri, Tareerat1
  • Varangrat, Anchalee1
  • Amico, K Rivet2
  • Chitwarakorn, Anupong3
  • Dye, Bonnie J4
  • Grant, Robert M5
  • Holtz, Timothy H1, 6
  • 1 Thailand Ministry of Public Health - U.S. Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand. , (Thailand)
  • 2 Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
  • 3 Silom Community Clinic @TropMed, Bangkok, Thailand. , (Thailand)
  • 4 FHI 360, Durham, NC, USA.
  • 5 Gladstone Institutes, University of California, San Francisco, CA, USA.
  • 6 Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Type
Published Article
Journal
AIDS care
Publication Date
Feb 01, 2020
Volume
32
Issue
2
Pages
249–254
Identifiers
DOI: 10.1080/09540121.2019.1623374
PMID: 31159584
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The HPTN 067/ADAPT Study evaluated the feasibility, acceptability, patterns of adherence and coverage for three randomly assigned oral FTC/TDF pre-exposure prophylaxis (PrEP) dosing regimens to prevent HIV infection. Using qualitative methods, we explored facilitators and barriers among a subset of men who have sex with men (MSM) participants in Bangkok, Thailand. Between August 2013 and March 2014, 32 HPTN 067/ADAPT participants joined in 6 focus group discussions, and 6 attended key informant interviews. Facilitators of PrEP adherence included use of strategies to have PrEP available when needed, simplicity in regimen requirements with recognition that more complex regimens may take some time to master, ability to plan for sex, receipt of social and technology support, ability to use a PrEP regimen that best matches to one's own patterns of sex, and experiences with PrEP as a part of health and well-being. Challenges to PrEP adherence included perceptions of no or low HIV risk, difficulties following regimens when intoxicated, concerns about side effects, experience of HIV stigma, and affordability of PrEP outside of study context influencing uptake and use in the community. Preferences for regimens varied, suggesting that multiple PrEP effective regimen options should be available to fit those with different needs.

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