The Neon Lights Study

A major goal in the fight against the HIV epidemic is increasing Pre-Exposure Prophylaxis (PrEP) adherence among cisgender sexual minority men (SMM), a population who makes up the majority of new HIV infections. When taken as recommended, PrEP is a highly effective once-daily pill that significantly reduces the chance of contracting HIV. 

SMM have a higher prevalence of alcohol use than in the overall population, however the impact of alcohol use and misuse on PrEP adherence is less established. This study will therefore explore the effect alcohol use has on PrEP adherence among cisgender SMM. 

From February 2022 through December 2022, 126 participants completed quantitative surveys, a self-guided timeline followback interview, twice-weekly diaries (10 weeks), qualitative interviews, and dried blood spot tests for HIV PrEP adherence and alcohol use testing. Data from this study are currently being analyzed and findings from this study will be used to identify factors to reduce harmful drinking and increase PrEP adherence.

AIM 1. Describe, quantitatively, patterns of alcohol use and sexual behavior among PrEP-using SMM who drink alcohol at baseline. Aim 1a. Retrospectively describe (quantitatively and qualitatively) experiences of and barriers to PrEP adherence (including alternate dosing schedules) at baseline.

AIM 2. Quantitatively identify the role that alcohol use plays in daily PrEP non-adherence among SMM. Aim 2a. Characterize the causal pathway of PrEP non-adherence via alcohol use and—e.g., individual and network—contextual factors. Aim 2b. Use multiple data sources (self-report in surveys and online dairies, DBS data) to pinpoint and validate estimates of alcohol use and PrEP use.

AIM 3. Contextualize PrEP non-adherence related to alcohol use using follow-up qualitative interviews. Aim3a. Characterize changes in perceptions of periods at risk and beliefs and attitudes about PrEP.