Evaluating Motivational Interviewing and Peer Adherence Support as Strategies to Improve Oral PrEP Adherence among HIV-Negative Adults in KwaZulu-Natal, South Africa

Bibliographic Data

ID22420955
AuthorsSherishka Dhindayal (0000-0002-7837-3216, Centre for the AIDS Programme of Research in South Africa, corresponding author), Sanele Mbeje (Centre for the AIDS Programme of Research in South Africa), Lara Lewis (0000-0001-5373-2086, Centre for the AIDS Programme of Research in South Africa), Hilton Humphries (0000-0001-8503-4127, Human Sciences Research Council), Leila E Mansoor (0000-0002-7607-348X, Centre for the AIDS Programme of Research in South Africa), Disebo Potloane (Centre for the AIDS Programme of Research in South Africa), Tanuja N Gengiah (0000-0002-3405-5128, Centre for the AIDS Programme of Research in South Africa), Quarraisha AbdoolKarim (Centre for the AIDS Programme of Research in South Africa)
Year2026
Publication date2026-07-11
Open AccessYes
TypeARTICLE
VenueAIDS and Behavior (JOURNAL)
Journal identifiersISSN: 1090-7165 • E-ISSN: 1573-3254
PublisherSpringer Science and Business Media LLC (PUBLISHER)
DOI10.1007/s10461-026-05233-z
PMID42432403
OpenAlexW7167919401
LanguageEN
References cited50

Consistent adherence is essential for the effectiveness of daily oral pre-exposure prophylaxis (PrEP) in preventing HIV. Motivational interviewing (MI) and peer adherence support (PAS) are adherence support strategies, providing individualized support and may enhance both adherence to oral PrEP and continued use over time. This study aimed to evaluate the impact of implementation-adapted MI and PAS approaches on oral PrEP adherence and identify predictors of referral for adherence support. This MI/PAS intervention was embedded in the CAPRISA 084 PrEP demonstration study (2016–2018) and operated as a sequential, stepped adherence support approach rather than participant-selected alternatives: poor adherence triggered referral for MI, while participants with sustained/persistent adherence challenges ( 5 years was protective (aHR 0.71, 95% CI 0.55–0.92). Participants referred for MI/PAS had nearly twice the odds of missing their subsequent visit compared with those not referred (OR 1.96; 95% CI 1.56–2.47). In a subset of 45 (5.9%) participants with drug-level data, tenofovir diphosphate concentrations increased significantly after MI/PAS (mean difference 154.7 fmol/punch; 95% CI 69.4–240; t(44) = 3.66; p

Health psychology · Intervention (counseling) · Logistic regression · Medication adherence · Motivational interviewing · Pill · Public health · Referral · HIV-related health complications and treatments · HIV/AIDS Research and Interventions · Mobile Health and mHealth Applications

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