SUPPORTING ADHERENCE Common Reasons for Low Adherence to ART Voluntary vs. Involuntary Non-adherence Voluntary Non-Adherence Involuntary Non-Adherence Not convinced PrEP is needed Forgot to take pill Does not believe PrEP works or is working Forgot to refill prescription Does not like taking pills Has competing priorities (e.g. employment, child care) Has experienced side-effects; wishes to avoid side effects Has difficulty with personal organization and scheduling Has experienced stigma while taking PrEP Affected by depression or other Does not believe it is necessary to take unaddressed mental illness every day Can not afford PrEP (in settings where Does not want to take with alcohol or other clients pay for PrEP services) drugs Does not want/has no time/cannot afford Wishes to avoid others witnessing to come to health care facility Dissatisfaction with health care provider interactions No place to store medication Unaddressed substance use issues, especially dependence on alcohol or other drugs Insufficient food to take pills Adherence Lessons from ART Programs Health providers can positively influence adherence by: Facilitating accurate knowledge and understanding of medication benefıts and requirements Preparing for and managing side-effects Monitoring of adherence Identifying social support Encouraging medication optimism Building self-effıcacy for adherence Developing a routinized daily schedule in which to integrate regular dosing Maintaining an open line of communication with PrEP clients Approaches to PrEP Medication Adherence Support
SUPPORTING ADHERENCE Common Reasons for Low Adherence to ART Voluntary vs. Involuntary Non-adherence Voluntary Non-Adherence Involuntary Non-Adherence Not convinced PrEP is needed Does not believe PrEP works or is working Does not like taking pills Has experienced side-effects; wishes to avoid side effects Has experienced stigma while taking PrEP Does not believe it is necessary to take every day Does not want to take with alcohol or other drugs Wishes to avoid others witnessing Forgot to take pill Forgot to refill prescription Has competing priorities (e.g. employment, child care) Has difficulty with personal organization and scheduling Affected by depression or other unaddressed mental illness Can not afford PrEP (in settings where clients pay for PrEP services) Does not want/has no time/cannot afford to come to health care facility Dissatisfaction with health care provider interactions No place to store medication Unaddressed substance use issues, especially dependence on alcohol or other drugs Insufficient food to take pills Adherence Lessons from ART Programs Health providers can positively influence adherence by: Facilitating accurate knowledge and understanding of medication benefıts and requirements Preparing for and managing side-effects Monitoring of adherence Identifying social support Encouraging medication optimism Building self-effıcacy for adherence Developing a routinized daily schedule in which to integrate regular dosing Maintaining an open line of communication with PrEP clients Approaches to PrEP Medication Adherence Support
PrEP_Participant_Manual_7.25.2017.docx