Variables Affecting PrEP Adherence in Black MSM

In South Africa, there are a predicted 800 thousand to 1.8 million men who have sex with men (MSM). This is a key population to target for HIV prevention since MSM in 38 low- and middle-income countries are 19 times more likely to be infected with the virus than the average, heterosexual male. (1)

Subsequently, MSM was the targeted population for clinical trials involving PrEP (Pre-Exposure Prophylaxis).  PrEP, a combination of emtricitabine and tenofovir taken systematically once a day by HIV negative individuals, has the potential to reduce HIV infection up to 96%. The first PrEP study was conducted in South Africa under the protocol iPrEx in 2010.

Brian Kanyemba, a doctoral candidate, is PhD at the University Of Cape Town, School of Public Health and Family Medicine in collaboration Division of Social and Behavioural Sciences. His topic is aiming to determine the predictors that influence MSM to adhere to PrEP as a key to uncovering prevention solutions that will beat HIV. To understand the predictors of PrEP adherence in black MSM, it is important to know what factors contribute to optimal use of PrEP for this population.

This study will look at data from the iPrex and Sibanye studies. iPrex indicated that there was a need to develop strategies to increase PrEP-usage amongst MSM with high-risk of HIV infection; the results showed that nearly half of the men on PrEP who would have caught HIV didn’t. The Sibanye was a global overview of MSM data indicating that regular HIV testing and condom use can decrease the incidence of HIV in MSM, who whilst at high risk are also enthusiastic about prevention. Once researchers understand the predictors of adherence, PrEP can be tailored to maximize the success of HIV prevention packages.

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The study will conduct interviews and focus groups to discuss the levels of understanding of PrEP and adherence in black MSM. These will be seeking factors that affect adherence, including economic, community, health and sexual factors. This will be augmented by secondary data analysis from iPrEX and Sibanye existing databases from both Cape Town and Port Elizabeth. Studies conducted on PrEP adherence in MSM will be collated, with data from over 250 participants.

A mixed method analysis will include looking for variables such as condom use and sexual partners summaries, to more unusual factors such as beliefs in study pills and relationships with drugs and alcohol. Kanyemba hopes to extend the literature on factors that support adherence to PrEP in this population.


The Desmond Tutu HIV Foundation wishes Kanyemba the best of luck in his research.



  1. Confirmed by the South African study


Written by Caroline Reid