Challenges to PrEP Use and Perceptions of Urine Tenofovir Adherence Monitoring Reported by Individuals on PrEP

This study explored challenges in accessing and adhering to HIV pre-exposure prophylaxis (PrEP) among participants from a large U.S. urban clinical center and evaluated the effectiveness of urine tenofovir (TFV) monitoring for adherence. It found that 65% of participants began PrEP within 1-3 months of learning about it, though 35% faced providers unwilling to prescribe it. The main barrier to adherence was remembering to take the medication (44%), rather than cost or stigma. Urine TFV monitoring was well-received, with participants preferring it every 3 months over other methods like finger prick or hair follicle testing. The study underscored the need to reduce obstacles to PrEP use and supported urine TFV monitoring as a reliable adherence measure.