HIV Prevention: Digital Health Interventions to Improve Adherence to HIV Pre-Exposure Prophylaxis (PrEP)

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This is a brief summary of the CPSTF finding and systematic review evidence for HIV Prevention: Digital Health Interventions to Improve Adherence to HIV Pre-Exposure Prophylaxis (PrEP). Read a complete summary of the systematic review and CPSTF finding.

This information is also available in a PDF version [PDF – 148 KB].

Summary of Community Preventive Services Task Force Recommendation

TThe Community Preventive Services Task Force (CPSTF) recommends digital health interventions to increase adherence to HIV pre-exposure prophylaxis (PrEP)—medicine that reduces the risk of getting HIV when taken as prescribed. Systematic review evidence shows these interventions improve both daily-use pill taking and retention in PrEP care. This improves health for population groups who are not infected with HIV and engage in behaviors that may increase their chances of getting HIV.

Major Findings

The CPSTF recommendation is based on evidence from 7 studies (search period from January 2000 to September 2021). When compared with standard care, interventions increased adherence to PrEP.

  • “Good adherence” (defined as taking four or more doses of PrEP per week) increased by a median of 10.0 percentage points or a median of 11.1% (5 studies).
  • “Excellent adherence” (defined as taking seven doses of PrEP per week) increased by a median of 20.0 percentage points or a median of 122.4% (3 studies).

What are Digital Health Interventions to Improve Adherence to HIV PrEP?

Interventions use text messages, mobile apps, phone calls, or websites to deliver reminders, guidance, and support that may be tailored to an individual’s needs. Participants must be HIV-negative and have a prescription for PrEP consistent with CDC guidelines.1 Interventions provide one or more of the following:

  • Information about HIV, PrEP and strategies for medication adherence
  • Services intended to motivate participants such as automated or interactive feedback, online forum discussions, virtual support groups, or adherence self-tracking
  • Regular reminders for medications, virtual check-in appointments, and clinic visits

Interventions may be combined with in-person activities such as one-on-one counseling, peer-led group sessions, or patient navigation.

Why is This Important?

  • When taken daily as prescribed, PrEP reduces the risk of getting HIV from sex by 99% and from injection drug use by at least 74%.2
  • Fewer than 25% of the approximately 1 million Americans who could benefit from PrEP are using it.3
  • Among groups disproportionately affected by HIV, only 27% of Black/African American, 31% of Hispanic/Latino, and 42% of White gay and bisexual men who could have benefitted from PrEP used it in 2017.4
  • The U.S. Preventive Services Task Force (USPSTF) recommends clinicians offer PrEP to persons who are at higher risk of HIV acquisition.5
  • Digital health interventions to increase adherence to HIV PrEP support the U.S. Department of Health and Human Service initiative to end the HIV epidemic.6

Learn More

CDC HIV

References

1 U.S. Public Health Service. Preexposure Prophylaxis for the Prevention of HIV Infection in the United States – 2021 Update: A Clinical Practice Guideline. Centers for Disease Control and Prevention (CDC), 2021.

2 CDC. Pre-Exposure Prophylaxis (PrEP). CDC, 2022. Available from URL: www.cdc.gov/hiv/risk/prep/. Accessed 7/12/22.

3 CDC. Ending the HIV Epidemic in the U.S. (EHE): Prevent HIV. CDC, 2022. Available from URL: www.cdc.gov/endhiv/prevent.html. Accessed 7/12/22.

4 CDC. Vital Signs. HIV and Gay and Bisexual Men: Differences in Knowledge of Status, Prevention, Treatment, and Stigma Exist by Race/Ethnicity. CDC, 2021. Available from URL: www.cdc.gov/vitalsigns/hivgaybimen/index.html. Accessed 7/12/22.

5 U.S. Preventive Services Task Force. Prevention of Human Immunodeficiency Virus (HIV) Infection: Preexposure Prophylaxis. USPSTF, 2022. Available from URL: www.uspreventiveservicestaskforce.org/uspstf/draft-update-summary/prevention-human-immunodeficiency-virus-hiv-infection-prep. Accessed 7/12/22.

6 CDC. Ending the HIV Epidemic: A Plan for America. CDC, 2020. Available from URL: www.cdc.gov/endhiv/index.html. Accessed 12/7/20.

Established in 1996 by the U.S. Department of Health and Human Services, the Community Preventive Services Task Force (CPSTF) is an independent, nonfederal panel of public health and prevention experts whose members are appointed by the director of CDC. CPSTF provides information for a wide range of decision makers on programs, services, and other interventions aimed at improving population health. Although CDC provides administrative, scientific, and technical support for CPSTF, the recommendations developed are those of CPSTF and do not undergo review or approval by CDC. Find more information at www.thecommunityguide.org.