title: Optimizing adherence to preexposure and postexposure prophylaxis: the need for an integrated biobehavioral approach.
abstract: Preexposure prophylaxis (PrEP) and postexposure prophylaxis (PEP) has been shown to be effective in preventing transmission of human immunodeficiency virus (HIV). A dose-response relationship between adherence and HIV transmission is illustrated in the current PrEP literature, and adherence interventions for PrEP may be useful, although currently few effective programs have been developed and tested. There is a paucity of randomized controlled trials testing PEP adherence interventions, and further research is needed. We conclude by proposing the importance of tailoring adherence counseling to address psychosocial factors and mental health stressors that may negatively affect adherence.
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital Harvard Medical School Fenway Health.
authors.forename: Aaron J
authors.initials: AJ
authors.lastname: Blashill
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital.
authors.forename: Peter P
authors.initials: PP
authors.lastname: Ehlinger
authors.affiliation: Harvard Medical School Fenway Health Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Mayer
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital Harvard Medical School Fenway Health.
authors.forename: Steven A
authors.initials: SA
authors.lastname: Safren
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D000066949:Biobehavioral Sciences / Q000379:methods; D003376:Counseling; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission*; D006801:Humans; D055118:Medication Adherence / Q000523:psychology; D008603:Mental Health; D056990:Post-Exposure Prophylaxis; D065129:Pre-Exposure Prophylaxis; D011584:Psychology; D013315:Stress, Psychological; D016896:Treatment Outcome
chemical_list: D019380:Anti-HIV Agents
keywords: HIV; PEP; PrEP; adherence; mental health