FEM-PrEP Participants’ Explanations for Overreporting Adherence to Pills and for the Whereabouts of Unused Pills

Authors: Amy L. Corneli, PhD, MPH; Kevin McKenna, MPH; Brian Perry, MPH

Researchers have been struggling to determine the efficacy of FEM-PrEP in research trials. Study participants report high adherence, and pill counts suggest the same. However, drug concentrations reveal low pill use. This study conducted interviews with former FEM-PrEP study participants to understand why women who are not using their study pills tell the research staff something different, and where unused pills wind up.

Interviews were conducted with 88 former FEM-PrEP participants in Kenya and South Africa. 31% said they had overreported adherence because they feared nonadherence would result in trial termination, despite repeated messages that nonadherence would not upset staff nor compromise their participation in the trial. Many participants said other participants had counted and removed pills from their bottles to appear adherent.

The study concluded that efforts to improve self-reporting is imperative, and should include alternative methods for creating supportive environments that allow participants to feel comfortable reporting actual adherence.

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