ArticleJournal of acquired immune deficiency syndromes (1999)2019
PrEP Discontinuation and Prevention-Effective Adherence: Experiences of PrEP Users in Ugandan HIV Serodiscordant Couples.
Article in Journal of acquired immune deficiency syndromes (1999), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
25 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Strategies to Improve PrEP Adherence in People Who Use Drugs: A Systematic Review.AIDS and behavior · 2026Pooled it
- Oral preexposure prophylaxis continuation, measurement and reporting.AIDS (London, England) · 2020Pooled it
- Alignment of PrEP adherence with periods of HIV risk among adolescent girls and young women in South Africa and Zimbabwe: a secondary analysis of the HPTN 082 randomised controlled trial.The lancet. HIV · 2022Trial
- Defining HIV Pre-Exposure Prophylaxis (PrEP) Persistence: A Scoping Review.Journal of the International AIDS Society · 2026Article
- High adherence to oral daily PrEP in a real-world implementation project in Kenya: a brief communication.AIDS research and therapy · 2026Article
- Barriers to and Facilitators of Heterosexual Men's Engagement with the PrEP Care Continuum in Sub-Saharan Africa: A Scoping Review.AIDS and behavior · 2026Article
- Factors associated with awareness of and willingness to use PrEP among stable, heterosexual HIV-serodifferent couples in seven African countries, 2019-2022.Journal of the International AIDS Society · 2025Article
- Alignment of PrEP adherence and HIV exposure risk among pregnant and postpartum women in Lilongwe, Malawi.PloS one · 2025Article
- Multi-stakeholder analysis of needs, perceptions, and sociocultural influences on multipurpose prevention technologies (MPT) in India.BMC public health · 2024Article
- Barriers and facilitators to uptake and persistence on prep among key populations in Southern Province, Zambia: a thematic analysis.BMC public health · 2024Article
- Discontinuation of HIV oral pre-exposure prophylaxis: findings from programmatic surveillance within two general population HIV programs in Nigeria.BMC public health · 2024Article
- HIV pre-exposure prophylaxis use during periods of unprotected sex among female sex workers in Tanga city, Tanzania: a control arm analysis of the pragmatic quasi-experimental trial.Frontiers in public health · 2024Article
- Pre-Exposure Prophylaxis and HIV Prevention Among Key Populations in Nigeria.International journal of MCH and AIDS · 2024Article
- Mobile Phone Technology for Preventing HIV and Related Youth Health Problems, Sexual Health, Mental Health, and Substance Use Problems in Southwest Uganda (Youth Health SMS): Protocol for a Pilot Randomized Controlled Trial.JMIR research protocols · 2023Article
- Awareness of Heightened Sexual and Behavioral Vulnerability as a Trigger for PrEP Resumption Among Adolescent Girls and Young Women in East and Southern Africa.Current HIV/AIDS reports · 2023Review
- Preparing for long-acting PrEP delivery: building on lessons from oral PrEP.Journal of the International AIDS Society · 2023Article
- Infectious Diseases Institute at Makerere University College of Health Sciences: a case study of a sustainable capacity building model for health care, research and training.African health sciences · 2022Article
- Safety of G2-S16 Polyanionic Carbosilane Dendrimer as Possible HIV-1 Vaginal Microbicide.International journal of molecular sciences · 2022Article
- HIV-serodifferent couples' perspectives and practices regarding HIV prevention strategies: A mixed methods study.PLOS global public health · 2022Article
- Multi-level Interventions to Promote Oral Pre-exposure Prophylaxis Use Among Adolescent Girls and Young Women: a Review of Recent Research.Current HIV/AIDS reports · 2021Review
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundOptimal adherence to oral pre-exposure prophylaxis (PrEP) for HIV prevention involves aligning consistent PrEP use with periods of risk to achieve prevention-effective adherence. Prevention-effective adherence is predicated on individuals discontinuing PrEP during periods without expected risk. For stable, serodiscordant couples, antiretroviral therapy (ART) adherence by the HIV-positive partner markedly decreases HIV transmission risk, potentially obviating the need for continued PrEP use; yet little is known about actual lived experiences of discontinuing PrEP.
methodsIn-depth qualitative interviews were conducted with HIV-uninfected PrEP users in serodiscordant couples taking part in the Partners Demonstration Project at IDI-Kasangati, Kampala, Uganda. Open-ended interviews elicited information on the partnered relationship; understandings of PrEP; prevention strategies; and experiences of PrEP discontinuation. An inductive, thematic, content-analytic approach was used to analyze study data.
resultsUninfected partners experienced PrEP as a valued resource for preventing HIV acquisition. Despite ongoing ART use by HIV-positive partners for a period of time consistent with viral suppression, discontinuation of PrEP was experienced as a loss of protection and a corresponding increase in risk of HIV acquisition. Uninfected partners responded with strategies aimed at offsetting this subjective sense of increased risk, specifically: (1) changing sexual practices; (2) prioritizing fidelity in the relationship; (3) increasing reliance on condoms; and (4) seeking evidence of partners' ART adherence.
conclusionsThese experiences highlight the challenges PrEP users in serodiscordant couples face in discontinuing PrEP for prevention-effective adherence. Flexible interventions that support individuals during this transition may increase comfort with discontinuing PrEP when alternative prevention strategies provide protection, such as a partner's consistent adherence to ART.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.