What's love got to do with it? Explaining adherence to oral antiretroviral pre-exposure prophylaxis for HIV-serodiscordant couples.

摘要: OBJECTIVE: Adherence may be the "Achilles heel" of pre-exposure prophylaxis (PrEP) a promising biomedical approach to HIV prevention. This article presents an explanation PrEP adherence for African serodiscordant couples derived from qualitative data. DESIGN: Explaining quantitative findings is one way investigation contributes research in medicine and public health. interview study was nested Partners Study phase III randomized trial evaluating oral tenofovir emtricitabine/tenofovir prevent acquisition by HIV-uninfected partners heterosexual couples. METHODS: In-depth interviews were provided 60 participants Uganda. Interviews used open-ended questions eliciting information on experiences barriers facilitators. An inductive informed grounded theory methodology analyze RESULTS: The proposed summarized as follows. Serodiscordance destabilizes HIV-negative partner reacts with anger fear sadness implication infidelity represented infection. A "discordance dilemma" ensues desire avoid acquiring advantages preserving relationship become competing priorities. seen solution-a means safeguarding health without ending relationship. users benefit support who reinforce adherence. Where discord persists suffers. CONCLUSIONS: understood function reduce risk although partnered use stable associated improved thus greater effectiveness.