Digital Health Interventions Increase Adherence to HIV PrEP

Content From: Amy Lansky, PhD, MPH, Director, Community Guide Office, Centers for Disease Control and Prevention , and Robyn Neblett Fanfair, MD, MPH, Captain, USPHS, Acting Director, Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention Published: December 13, 20223 min read

Topics

OIDP_HIVgov_Blog-Email-Lansky-Fanfair

The Community Preventive Services Task Force (CPSTF) recently recommended digital health interventions to increase adherence to HIV Pre-Exposure Prophylaxis (PrEP)Exit Disclaimer—medicine that reduces the risk of getting HIV when taken as prescribed.1 A systematic review of evidence from seven studies shows interventions improve both consistent pill taking and retention in PrEP care, thus improving health for population groups who are not infected with HIV and engage in behaviors that may increase their chances of getting HIV. This recommendation supports the Ending the HIV Epidemic in the U.S. initiative from the U.S. Department of Health and Human Services.

The CPSTF recommendation is based on evidence from a systematic review conducted by a team of specialists in systematic review methods, and in research, practice, and policy related to HIV prevention, treatment, and care. Scientists from CDC’s Division of HIV Prevention and Community Guide OfficeExit Disclaimer partnered on the review.

Results showed that when compared with standard care, digital health interventions increased the proportion of people who reported “good adherence” to HIV PrEP (defined as taking four or more doses of PrEP per week) by a median of 11.1%. The proportion of people who reported “Excellent adherence” (defined as taking seven doses of PrEP per week) increased by a median of 65.4%.

What Are Digital Health Interventions to Increase Adherence to HIV PrEP?

These interventions use text messages, mobile apps, phone calls, or websites to deliver individually tailored reminders, guidance, and support. Participants must be HIV-negative and have a prescription for PrEP consistent with CDC guidelines.2 Digital health interventions provide one or more of the following:

  • Information about HIV, PrEP, and strategies for medication adherence
  • Services intended to motivate participants such as automated or interactive feedback, online forum discussions, virtual support groups, or adherence self-tracking
  • Regular reminders for medications, virtual check-in appointments, and clinic visits

Interventions may be combined with in-person activities such as one-on-one counseling, peer-led group sessions, or patient navigation.

Why Is This Important?

Ending the HIV Epidemic in the U.S. is the operational plan developed by agencies across the U.S. Department of Health and Human Services to pursue the goal of reducing new HIV infections by 75% by 2025 and 90% by 2030. For the United States to achieve these goals, steps must be taken to prevent new HIV infections. When taken daily as prescribed, PrEP reduces the risk of getting HIV from sex by 99% and from injection drug use by at least 74%.3 Helping people with PrEP adherence is an important prevention tool to help reach these HIV prevention goals.

For more information, view The Community Guide’s new resources:

The Community Guide is a collection of evidence-based findingsExit Disclaimer of the Community Preventive Services Task Force (CPSTF)Exit Disclaimer. It is a resource to help you select interventions to improve health and prevent disease in your state, community, community organization, business, healthcare organization, or school. Learn moreExit Disclaimer.

Read HIV-related CPSTF recommendations for: Partner Services Interventions Increase HIV Testing and are Cost-effectiveExit Disclaimer and Clinical Decision Support Systems to Increase HIV ScreeningExit Disclaimer.

References

1 Guide to Community Preventive Services. HIV Prevention: Digital Health Interventions to Improve Adherence to HIV Pre-Exposure Prophylaxis. Available from URL: https://www.thecommunityguide.org/findings/hiv-prevention-digital-health-interventions-improve-adherence-hiv-pre-exposure-prophylaxis.htmlExit Disclaimer. Accessed 11/28/22.

2 U.S. Public Health Service. Preexposure Prophylaxis for the Prevention of HIV Infection in the United States – 2021 Update: A Clinical Practice Guideline. CDC, 2021. Available from URL: https://www.cdc.gov/hiv/pdf/risk/prep/cdc-hiv-prep-guidelines-2021.pdf(PDF, 1.57MB). Accessed 11/28/22.

3 CDC. Pre-Exposure Prophylaxis (PrEP). CDC, 2022. Available from URL: www.cdc.gov/hiv/risk/prep/. Accessed 7/12/22.