ArticleBMC public health2020
Adherence to recommendations for ART and targeted PrEP use among HIV serodiscordant couples in East Africa: the "PrEP as a bridge to ART" strategy.
Article in BMC public health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis 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
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- Pre-exposure Prophylaxis Adherence Among Men Who Have Sex With Men: A Systematic Review and Meta-analysis.Journal of preventive medicine and public health = Yebang Uihakhoe chi · 2024Pooled it
- PrEP Cascade and Barriers Among Serodifferent Couples in Rural Tanzania: A Prospective Study on Awareness, Uptake, Adherence, and Retention.AIDS and behavior · 2026Article
- Interventions for thriving in HIV serodiscordant relationships in Sub-Saharan Africa: a scoping review.BMC public health · 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
- Motivations, benefits, and barriers to the use of HIV pre-exposure prophylaxis based on the health belief model.Revista latino-americana de enfermagem · 2025Article
- Impact of an analytical treatment interruption on partners and family members of trial participants in Durban, South Africa: a qualitative study.Frontiers in public health · 2025Article
- Barriers and facilitators to uptake and persistence on prep among key populations in Southern Province, Zambia: a thematic analysis.BMC public health · 2024Article
- The Effect of Disclosure of PrEP Use on Adherence Among African Young Women in an Open-Label PrEP Study: Findings from HPTN 082.AIDS and behavior · 2024Article
- Using an Intersectional Framework to Understand the Challenges of Adopting Pre-exposure Prophylaxis (PrEP) Among Young Adult Black Women.Sexuality research & social policy : journal of NSRC : SR & SP · 2022Article
- Communication needs for improved uptake of PrEP and HIVST services among key populations in Nigeria: a mixed-method study.AIDS research and therapy · 2021Article
- Serodiscordance predictors among couples in the HIV context: implications for health care.BMC public health · 2021Article
- "We are in this together:" dyadic-level influence and decision-making among HIV serodiscordant couples in Tanzania receiving access to PrEP.BMC public health · 2021Observational
- Pre-exposure prophylaxis use among HIV serodiscordant couples: a qualitative study in Mozambique.Global health action · 2021Article
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 3 countries.
Funding
Abstract
backgroundPrEP use should be aligned with periods of risk for HIV acquisition. For HIV serodiscordant couples, PrEP can be used as a bridge until the partner living with HIV takes antiretroviral therapy (ART) long enough to achieve viral suppression (the "PrEP as a Bridge to ART" strategy). However, adherence to this strategy is unknown.
methodsIn a demonstration project in Kenya and Uganda, HIV-uninfected partners of serodiscordant couples were advised to take PrEP until the partner living with HIV took ART for ≥ 6 months. PrEP discontinuation was then recommended unless there were concerns about ART adherence, immediate fertility intentions, or outside partners with unknown HIV/ART status. Electronic adherence monitoring and socio-behavioral questionnaire data were used in logistic regression models to explore completion of this strategy and continuation of PrEP beyond recommendations to stop its use.
resultsAmong 833 serodiscordant couples, 436 (52%) HIV-uninfected partners completed ≥ 6 months of PrEP as a bridge to ART. Strategy completion was associated with older age (aOR per 5 years = 1.1; p = 0.008) and having fewer children (aOR = 0.9; p = 0.019). Of the 230 participants encouraged to stop PrEP according to strategy recommendations, 170 (74%) did so. PrEP continuation among the remaining 60 participants was associated with more education (aOR = 1.1; p = 0.029), a preference for PrEP over ART (aOR = 3.6; p = 0.026), comfort with managing their serodiscordant relationship (aOR = 0.6; p = 0.046), and believing PrEP makes sex safe (aOR = 0.5; p = 0.026).
conclusionHalf of participants completed the PrEP as a bridge to ART strategy and the majority stopped PrEP as recommended. These findings suggest that targeting PrEP to periods of risk is a promising approach; however, tailoring counseling around aligning PrEP use and HIV risk will be important for optimal strategy implementation.
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