A Systematic Review of Oral Pre-exposure Prophylaxis HIV Adherence Interventions.

The review included only peer-reviewed studies from 2012 to June 2021, and it did not exclude studies for poor methodological quality. Many studies were small, pilot, or nested within larger PrEP trials, and no study blinded participants and outcome assessors. Adherence was measured in different ways, including dried blood spot levels, pill counts, electronic bottle caps, and self-report, so the studies could not be pooled. Some interventions combined several components, such as text messages with peer navigation or group meetings, so the contribution of any single component cannot be separated. Most studies were conducted in the United States and focused on groups already represented in PrEP research, so findings may not apply to underrepresented populations. The review did not perform a meta-analysis, so it cannot provide a combined effect size.

The authors reported no real or perceived vested interests. The article is tagged as supported by non-U.S. government research.

Do not conclude that PrEP adherence interventions reliably improve adherence. Ten studies reported improved adherence and five found no difference, and the review could not pool results because interventions and adherence measures were heterogeneous.