The Impact of Alcohol and Illicit Drug use on Adherence to HIV Pre-exposure Prophylaxis among Men who have Sex with Men

Objectives: To investigate the degree of Men who have Sex with Men (MSM) adherence to antiretrovirals Tenofovir/Emtricitabine (TFC/FTC), drugs for the Pre-exposure Prophylaxis to the human immunodeficiency virus (PrEP). Methods: This is a cross-sectional and retrospective study carried out in a reference service in infectology in Ceará-Brazil. MSM with at least three recorded medical follow-ups were included in the study. We considered as ideal adherence those users who took at least 80% of the doses within 90 days. Bivariate analysis (X² or Fisher’s exact) was carried out to investigate the association between ideal adherence to PrEP and the use of alcohol and illicit drugs. Results with a p-value <0.05 were taken into consideration. Results: A total of 167 individuals participated in the survey. MSM stopped taking 668 doses of PrEP in three months, of which 16.2% (n=27) had an adherence rate >80%. Nevertheless, alcohol and illicit drug use accounted for 41.4% (n=69). Among the most commonly used narcotics were marijuana and cocaine, 42.7% (n=35) and 18.3% (n=15), respectively. It was observed that optimal adherence (>80%) was better in individuals who did not use alcohol and illicit drugs compared to those who did (p=0.003). Conclusion: MSM adhered satisfactorily to PrEP; however, it was observed that individuals who used illicit drugs and alcohol when had their degree of adherence to TDF/FTC weakened when compared to those who did not use them. Thus, it becomes necessary to pay attention to such aspects to provide alternatives for increasing adherence in highpriority populations.