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Substance Use and Adherence to HIV Pre-Exposure Prophylaxis in Studies Enrolling Men Who Have Sex with Men and Transgender Women: A Systematic Review.
- Source :
- AIDS & Behavior; Jul2023, Vol. 27 Issue 7, p2131-2162, 32p, 1 Diagram, 5 Charts
- Publication Year :
- 2023
-
Abstract
- Optimal adherence to pre-exposure prophylaxis (PrEP) is critical, but challenging. Men who have sex with men and transgender women have high rates of HIV incidence and substance use. Substance use is associated with reduced adherence to other medications, but associations between substance use and adherence to PrEP are less clear. Thus, the current review 1) systematically evaluates the measurement of substance use and PrEP adherence in studies examining both and 2) summarizes reported findings. Peer-reviewed articles published between 2010 - April 2021 examining associations between substance use and PrEP adherence were reviewed. Fifty studies met inclusion criteria. Assessment of substance use (i.e., mostly via self-reports at baseline) and PrEP adherence (i.e., often via tenofovir diphosphate [TFV-DP] concentration levels at follow-up) varied considerably across studies. Many studies used categorical variables (e.g., substance use: yes/no). Studies using TFV-DP levels defined adherence consistently (i.e., TFV-DP ≥ 700 fmol/punch), with slight variations. Qualitative studies (n = 10) indicated that substance use (mainly alcohol) is related to poorer PrEP adherence. While quantitative findings to date are equivocal for alcohol, there is a pattern of findings linking stimulant use with poorer PrEP adherence. This review reveals four methodological gaps, which can be addressed in future research by: 1) use of uniform benchmarks for substance use measures, 2) prospective assessment for substance use, 3) use of continuous outcome variables wherever possible, and 4) more extensive consideration of potential confounders. Addressing these methodological gaps may help us reach more definitive conclusions regarding associations between substance use and PrEP adherence. [ABSTRACT FROM AUTHOR]
- Subjects :
- HIV infection epidemiology
DRUG therapy
DIPHOSPHONATES
HIV prevention
HIV infections
ANTI-HIV agents
ONLINE information services
SUBSTANCE abuse
MEDICAL information storage & retrieval systems
TRANS women
SYSTEMATIC reviews
SELF-evaluation
TENOFOVIR
PRE-exposure prophylaxis
TREATMENT effectiveness
HOMOSEXUALITY
DRUGS
RESEARCH funding
SEXUAL minorities
PATIENT compliance
MEN who have sex with men
MEDLINE
LONGITUDINAL method
Subjects
Details
- Language :
- English
- ISSN :
- 10907165
- Volume :
- 27
- Issue :
- 7
- Database :
- Complementary Index
- Journal :
- AIDS & Behavior
- Publication Type :
- Academic Journal
- Accession number :
- 163938708
- Full Text :
- https://doi.org/10.1007/s10461-022-03948-3