Published In

AIDS and Behavior

Document Type


Publication Date



HIV infections -- Kenya -- Treatment, AIDS (Disease) -- Kenya -- Treatment, HIV-positive gay men -- Kenya -- Behavior -- Qualitative studies

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8 pages


A qualitative assessment of Kenyan men who have sex with men taking daily and intermittent oral HIV preexposure prophylaxis (PrEP) found stigma, sex work, mobility, and alcohol impacted adherence. We analyzed quantitative data from the same cohort to explore different definitions of intermittent adherence. Volunteers were randomized to daily emtricitabine/tenofovir or placebo, or intermittent (prescription: Mondays/Fridays/after sex, maximum1 dose/day)emtricitabine/tenofovir or placebo (2:1:2:1), and followed for 4 months. By electronic monitoring, median adherence for daily dosing was 80 %. Median adherence for intermittent dosing was 71 % per a ‘‘relaxed’’ definition (accounting for off-prescription dosing) and 40 % per a ‘‘strict’’ definition (limited to the prescription). Factors associated with lower adherence included travel, transactional sex, and longer follow-up; higher adherence was associated with daily dosing and an income. The definition of intermittent dosing strongly affects interpretation of adherence. These findings suggest interventions should address challenges of mobility, sex work, and long-term PrEP.


At the time of writing, David Bangsberg was affiliated with Massachusetts General Hospital.

Origianlly appeared in Aids and Behavior, vol. 19, no. 5, 2015, published by Springer. May be found at

©The Author(s) 2014. This article is published with open access at



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