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PrEP risk perception and adherence among men who have sex with men: a prospective cohort study based on growth

Bing Lin1,2, Jiaxiu Liu3, Xiaoni Zhong4,5

  • 1School of Public Health, Chongqing Medical University, Chongqing, China.

BMC Infectious Diseases
|December 30, 2022
PubMed
Abstract

Insights

High perceived risk regarding pre-exposure prophylaxis (PrEP) negatively impacts adherence among men who have sex with men (MSM). Addressing these concerns is crucial for effective PrEP implementation in this population.

Area of Science:

  • Public Health
  • Epidemiology
  • Behavioral Science

Background:

  • Pre-exposure prophylaxis (PrEP) risk perception is defined as negative experiences or concerns associated with its use.
  • Understanding the longitudinal trajectory of PrEP risk perception among men who have sex with men (MSM) is essential for adherence.

Purpose of the Study:

  • To explore the longitudinal trajectory of PrEP risk perception among MSM.
  • To investigate the impact of PrEP risk perception on adherence to medication.

Main Methods:

  • Prospective cohort study in Western China (2013-2015) involving MSM.
  • Growth Mixture Model (GMM) used to classify longitudinal PrEP risk perception trajectories.
  • Generalized Estimating Equations (GEE) analyzed the effect of risk perception on adherence.

Main Results:

  • Two distinct PrEP risk perception groups identified: high-risk (n=133) and low-risk (n=493).
  • High levels of PrEP risk perception were associated with lower drug adherence (57.89% vs. 68.35%, p=0.024).
  • High risk perception significantly hindered adherence (RR=0.71, 95% CI 0.50-0.99, p=0.046).

Conclusions:

  • Elevated PrEP risk perception among MSM presents a significant barrier to medication adherence.
  • Interventions should focus on mitigating PrEP risk perception to improve adherence.
  • Findings are validated by subsequent PrEP projects (2019-2021).
Keywords:
AdherenceGrowth mixture modelMen who have sex with menPre-exposure prophylaxisRisk perception

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