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. 2018 Aug;30(4):275-286.
doi: 10.1521/aeap.2018.30.4.275.

How Do Gay and Bisexual Men Make Up for Missed PrEP Doses, and What Impact Does Missing a Dose Have on Their Subsequent Sexual Behavior?

Christian Grov  1 , Alexa B D'Angelo  1 , Anthony W P Flynn  2 , Javier Lopez-Rios  3 , David W Pantalone  4 , Ian W Holloway  5 , Thomas H F Whitfield  6 , Jeffrey T Parsons  6   7
Affiliations

How Do Gay and Bisexual Men Make Up for Missed PrEP Doses, and What Impact Does Missing a Dose Have on Their Subsequent Sexual Behavior?

Christian Grov et al. AIDS Educ Prev. 2018 Aug.

Abstract

HIV pre-exposure prophylaxis (PrEP) is being adopted by members of key populations, such as gay and bisexual men (GBM). Since adherence to a daily PrEP regimen ensures a maximum protection, it is critical to understand GBM's behavioral responses to having missed PrEP doses. We report on qualitative interviews with GBM taking PrEP. We identified three behavioral responses: (1) 59% continued with their next scheduled dose; (2) 49% described "making up" for a missed dose by taking medication as soon as possible; and (3) 11% reported "doubling" the next PrEP dose. Participants provided potentially contradictory narratives about their sexual behavior after a missed dose: (1) 54% described making no changes; (2) 49% described adjusting their sexual behavior to reduce HIV risk; and (3) 10% said their decision would be contingent upon how many doses were missed. For PrEP prescribers, our data provide a useful lens to understand patients' lived experiences with PrEP.

Keywords: HIV; adherence; gay and bisexual men; pre-exposure prophylaxis (PrEP); qualitative data.

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