Men who have sex with men (MSM) in serodiscordant relationships could benefit from dyad-level interventions to improve HIV medication adherence among both partners, a study published in Journal of Acquired Immune Deficiency Syndromes suggested.
The study analyzed data from Project Stronger Together, a randomized controlled trial of serodiscordant male couples in three U.S. metropolitan areas. One-hundred twenty HIV-negative partners were assessed every six months for a total of 24 months. At baseline, 42% of participants were on PrEP and 63% of partners living with HIV were virally suppressed.
PrEP use was found to be twice as common among participants whose partners had an undetectable HIV viral load compared to participants whose partners were viremic. By contrast, a partner’s level of self-reported HIV treatment adherence did not appear to affect a person’s decision to take PrEP—nor did whether the HIV-positive partner was currently taking HIV medications at all.
A person can encourage their partner’s healthy behavior; such concern, in turn, can strengthen the relationship, which in turn can increase both partners’ motivation to stay healthy by taking HIV medications for prevention or treatment, study authors theorized. Dyad-level interventions may help to start such a virtuous cycle. “We do want to emphasize the important [sic] of having collective goals because dyadic benefits of mutual pill-taking do exist,” study authors wrote.
All that said, in the era of U=U, mutually monogamous couples may not need PrEP if the HIV-positive partner has an undetectable viral load while on HIV treatment, the authors noted.
Study limitations included self-reported data, lack of information on insurance status, exclusively urban study sites, and the possibility that those volunteering for this study may be more health conscious than the general public.