Perspectives of Young Men Who Have Sex with Men on PrEP Adherence and Peer Navigation: A Qualitative Study

McKetchnie, Samantha M.; White, Bradley Patrick; Fontenot, Holly B.; Dormitzer, Julian; Psaros, Christina; Fitch, Calvin; O’Cleirigh, Conall; Mayer, Kenneth H.; Krakower, Douglas S.

doi:10.1007/s10508-023-02579-6

Cited by 5 publications

(3 citation statements)

References 41 publications

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Section: Discussionmentioning

confidence: 99%

“…However, our overall conclusions in support of peer navigation programs are strengthened by the positive experiences and perspectives on peer navigation programs for key populations that have focused on preexposure prophylaxis or HIV testing, instead of treatment support. [22][23][24] Although limited, available studies provide moderate certainty evidence for the potential benefits of HIV/VH/STI peer navigation programs for key populations. Further evaluations of programs designed for key populations are needed.…”

Section: • Remarksmentioning

confidence: 99%

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Do Peer Navigators Improve Initiation and Retention in HIV/VH/STI Treatment Programs for People From Key Populations? A Systematic Review of Effectiveness, Values and Preferences, and Cost

Kennedy,

Yeh,

Verster

et al. 2024

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background: Key populations are disproportionately affected by HIV, viral hepatitis (VH), and sexually transmitted infections (STIs) and face barriers to care. Peer navigation programs are widely used, but evidence supporting their use has not been synthesized. Setting: Peer navigation programs for sex workers, men who have sex with men, people who inject drugs, prisoners, and trans and gender diverse people globally. Methods: To inform World Health Organization guidelines, we conducted a systematic review of effectiveness, values and preferences, and cost studies published between January 2010 and May 2021. We searched CINAHL, PsycINFO, PubMed, and EMBASE; screened abstracts; and extracted data in duplicate. The effectiveness review included randomized controlled trials and comparative observational studies evaluating time to diagnosis or linkage to care, treatment initiation, treatment retention/completion, viral load, cure, or mortality. We assessed risk of bias and summarized findings in GRADE evidence profiles. Values and preferences and cost data were summarized descriptively. Results: Four studies evaluated the effectiveness of peer navigators for key populations. All were focused on HIV; none were designed for VH or STIs. These studies showed mixed effects on linkage to care, treatment retention/completion, and viral load; no studies measured treatment initiation, cure, or mortality. Two values and preferences studies with community-based organization staff and health workers suggested peer navigators for key populations were acceptable and valued, although continued challenges remained. No cost studies were identified. Conclusions: Although limited, available studies provide moderate certainty evidence for benefits of HIV/VH/STI peer navigation programs for key populations. Further evaluations are needed.

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Section: Discussionmentioning

confidence: 99%

Section: • Remarksmentioning

confidence: 99%

Do Peer Navigators Improve Initiation and Retention in HIV/VH/STI Treatment Programs for People From Key Populations? A Systematic Review of Effectiveness, Values and Preferences, and Cost

Kennedy,

Yeh,

Verster

et al. 2024

JAIDS Journal of Acquired Immune Deficiency Syndromes

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“…Peer navigation has been shown to be effective for antiretroviral adherence among people with HIV (PWH) 20,21 and qualitative work has demonstrated interest in peer navigation for PrEP use. 19,22 Bidirectional text messaging has been associated with more than twice the odds of having protective PrEP levels. 23 We developed a trial to evaluate if peer navigation, text messaging, and a combined intervention of both would support PrEP adherence among people who use methamphetamine.…”

Section: Introductionmentioning

confidence: 99%

Challenges recruiting and retaining people at risk for HIV who use methamphetamine in a randomized PrEP adherence trial in Seattle, WA

McMahan,

Atkins,

Buckler

et al. 2024

Int J STD AIDS

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Background Methamphetamine is associated with increased HIV risk and suboptimal adherence to pre-exposure prophylaxis (PrEP). Interventions to support PrEP adherence for people who use methamphetamine are needed. Methods We evaluated peer navigation to support adherence among people initiating PrEP who use methamphetamine. The HIV Prevention in Methamphetamine Users (HMU!) study enrolled participants from May 2018-January 2022 in Seattle, WA, and followed them for 6 months. Surveys collected sociodemographic, drug use, and sexual behavior data at enrollment, month 3, and month 6. Dried blood spots (DBS) were collected at months 1, 3, and 6 to measure PrEP adherence. Results We enrolled 21 participants of a target sample of 40, of whom 20 were prescribed PrEP. Nine participants (43%) received peer navigation and 12 (57%) received standard of care or text messaging. At baseline, most participants reported at least weekly methamphetamine use (17, 81%) and condomless receptive anal intercourse (CRAI) (16, 76%). One-third reported CRAI with a partner with HIV. Among those who provided a DBS, 78% and 50% had results commensurate with ≥4 pills/week at the month 3 and 6 visit, respectively. More than half of those prescribed PrEP completed a month 6 visit (11, 55%). Retention was not associated with peer support compared to standard of care or text messaging ( p = .20). Conclusions We enrolled half our target sample size despite extensive recruitment efforts. As expected, participants had challenges with PrEP adherence and persistence. While peer navigation interventions should be studied further, additional interventions are likely needed to support PrEP uptake, adherence, and persistence among people who use methamphetamine.

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A Pilot Randomized Controlled Trial of an mHealth Intervention to Improve PrEP Adherence Among Young Sexual Minority Men

Horvath,

Helm,

Black

et al. 2024

AIDS Behav

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Perspectives of Young Men Who Have Sex with Men on PrEP Adherence and Peer Navigation: A Qualitative Study

Cited by 5 publications

References 41 publications

Do Peer Navigators Improve Initiation and Retention in HIV/VH/STI Treatment Programs for People From Key Populations? A Systematic Review of Effectiveness, Values and Preferences, and Cost

Do Peer Navigators Improve Initiation and Retention in HIV/VH/STI Treatment Programs for People From Key Populations? A Systematic Review of Effectiveness, Values and Preferences, and Cost

Challenges recruiting and retaining people at risk for HIV who use methamphetamine in a randomized PrEP adherence trial in Seattle, WA

A Pilot Randomized Controlled Trial of an mHealth Intervention to Improve PrEP Adherence Among Young Sexual Minority Men

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