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Assessing the Impact of Digital Communication Tools on Oral PrEP Adherence: A Systematic Review and Meta-analysis
Julien Brisson1, Dorothy Apedaile2, Mariangela Castro-Arteaga3
1Social & Behavioural Health Sciences Division, Dalla Lana School of Public Health, University of Toronto, 155 College Street, 5 th Floor, Room 554, Toronto, ON, M5 T 3M7, Canada. j.brisson@utoronto.ca.
Digital tools like text messages modestly improved daily oral HIV pre-exposure prophylaxis (PrEP) adherence at 12 weeks, but the effect was not sustained. Further research is needed for long-term adherence strategies.
Area of Science:
- Public Health
- Digital Health
- HIV Prevention
Background:
- Daily oral HIV pre-exposure prophylaxis (PrEP) is crucial for HIV prevention.
- Adherence to daily oral PrEP can be challenging.
- Digital communication tools offer potential solutions for improving adherence.
Purpose of the Study:
- To systematically review and meta-analyze the effectiveness of digital communication tools in improving daily oral PrEP adherence.
- To evaluate the impact of interventions like text messages and mobile apps on PrEP adherence.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs) from 2012-2024.
- Searched major databases (PubMed, Embase, Web of Science, PsychInfo) and clinical trial registries.
- Pooled data from ten RCTs using random-effects meta-analysis to estimate risk ratios for adequate PrEP adherence.
Main Results:
- Digital interventions showed a modest improvement in PrEP adherence at 12 weeks (RR=1.08).
- No significant effect on PrEP adherence was observed at 24 weeks (RR=1.10).
- Interventions included text messaging, mobile applications, and mobile games, primarily studied in men who have sex with men (MSM) and transgender women (TW).
Conclusions:
- Digital communication tools have a limited impact on sustained daily oral PrEP adherence.
- Current digital strategies may not be sufficient for long-term adherence support.
- Development of diverse and sustained intervention strategies is necessary to improve PrEP adherence.
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