Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jul 20, 2020
Date Accepted: Sep 15, 2020
Geosocial Networking App Users Take more Risks, but with Poor Adherence to HIV Pre-exposure Prophylaxis: e-Health Should be Introduced to Promote PrEP Adherence
ABSTRACT
Background:
Over half of men who have sex with men (MSM) use geosocial networking app (GSN) to encounter sex partners, GSN users have become a unique large subpopulation among MSM concerning HIV prevention and control. Pre-exposure prophylaxis (PrEP) is a promising measure for HIV prevention, especially for MSM, but its effectiveness largely depends on medication adherence. However, little is known about PrEP adherence in GSN users, which is critical to addressing the overall optimization of PrEP compliance outside of clinical trials in the context of large-scale implementation.
Objective:
This study revealed the correlation of GSN use and medication adherence among MSM receiving PrEP, aiming to provide enlightenment to address the widespread improvement of adherence.
Methods:
This study based on the China Real-world Oral intake of PrEP (CROPrEP) project, a multicenter, real-world study of Chinese MSM attending daily and event-driven PrEP. Eligible participants completed a detailed computer-assisted self-interview (CASI) on sociodemographics, GSN use, and sexual behavior. Then participants were followed up for 12 months (e.g., PrEP delivery, adherence assessment, PrEP coverage of sex activities, and regimens switch). A generalized estimation equation was used to analyze the predictors of medication adherence and regimen conversion among GSN users and non-users.
Results:
At baseline, 74% of the 1,023 eligible participants, reported primarily using GSN to seek sexual partners, and GSN users are more likely to have high-risk behaviors such as multiple sex partners and condomless than other non-users (all p<.05). During follow-up, GSN-users have a significantly low level of pill-counting adherence than non-users (adjusted odds ratio [aOR]=.8, 95%CI=.6~1.0, p =.038). At event-driven group, GSN users had marginal lower levels of self-reported adherence (aOR=.7, p=.060) and lower PrEP coverage of sex practices (aOR=.6, p=.038). Additionally, GSN users seemed more likely to switch from event-driven to daily regimen (aOR=1.8, p=.084).
Conclusions:
GSN users are highly prevalent in MSM, despite their higher sexual risk, lower adherence levels, suggesting that e-Health needs to be introduced to the GSN platform to promote PrEP adherence. Clinical Trial: ChiCTR-IIN-17013762.
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