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Improving adherence to daily preexposure prophylaxis among MSM in Amsterdam by providing feedback via a mobile

Mark A M van den Elshout1, Elske Hoornenborg1, Roel C A Achterbergh1

  • 1Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands.

AIDS (London, England)
|May 18, 2021
PubMed
Abstract

Insights

Mobile app feedback did not improve pre-exposure prophylaxis (PrEP) adherence in a highly adherent group. However, it did increase excellent adherence rates among participants in the Amsterdam PrEP demonstration project.

Area of Science:

  • Public Health
  • Infectious Disease Prevention
  • Digital Health Interventions

Background:

  • Pre-exposure prophylaxis (PrEP) is a key strategy for HIV prevention.
  • Adherence to PrEP is crucial for its effectiveness.
  • Mobile applications offer potential for monitoring and improving adherence.

Purpose of the Study:

  • To evaluate the impact of automated mobile app feedback on PrEP adherence.
  • To assess the effect of visual feedback on self-reported PrEP use and adherence levels.

Main Methods:

  • A randomized clinical trial was conducted among men who have sex with men (MSM) in the Amsterdam PrEP demonstration project (AMPrEP).
  • Participants were randomized to a control or intervention app group, both allowing daily reporting.
  • Intracellular tenofovir diphosphate (TFV-DP) concentrations in dried blood spots were used to measure adherence at 12 and 24 months.

Main Results:

  • Overall, 13% of participants showed poor adherence, 87% good adherence, and 40% excellent adherence.
  • The intervention app did not significantly reduce the proportion of participants with poor adherence (16% vs. 11%, P=0.36).
  • The intervention app significantly increased the proportion of participants with excellent adherence (48% vs. 31%, P=0.026).

Conclusions:

  • Automated mobile app feedback did not improve poor adherence to PrEP in a highly adherent population.
  • The intervention showed a positive effect on achieving excellent adherence levels.
  • Further research may explore tailored feedback mechanisms for diverse adherence profiles.

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