Exploring Digital Platforms to Deliver Harm-Reduction Messaging to Enhance PrEP Adherence among Men who Misuse Alcohol: A Qualitative and Feasibility Study

About This Grant

Men remain disproportionately impacted by HIV, and while pre-exposure prophylaxis (PrEP) is a proven prevention strategy, its effectiveness is undermined by nonadherence linked to alcohol and illicit drug use. Digital platforms, widely used by men to connect, are associated with higher alcohol and illicit drug use, presenting both challenges and opportunities for intervention. This study explores the intersection of alcohol misuse and PrEP adherence among men, with a focus on the influence of digital platforms. This study uses qualitative methods, specifically semi- structured interviews and thematic analysis, to:(1) examine how digital platforms impact alcohol and illicit drugs use behaviors and their effects on PrEP care continuum among men who misuse alcohol, and; (2) assess the acceptability and feasibility of leveraging these platforms to deliver harm-reduction messaging for alcohol and illicit drug use moderation management to improve PrEP adherence among men who misuse alcohol in Kentucky. Preliminary findings from the parent study “Alcohol Misuse, Gut Microbial Dysbiosis and PrEP Care Continuum: Application and Efficacy of SBIRT Intervention”, (R01 AA030485) suggest men prefer harm- reduction approaches over abstinence for managing substance use, indicating potential receptivity to digital interventions. By exploring the feasibility and acceptability of integrating moderation management into messaging, this study aims to enhance PrEP adherence and inform the development of innovative, digitally delivered harm-reduction strategies tailored to this population. The findings will contribute to the future design of scalable, community-focused solutions to address overlapping public health challenges of alcohol misuse, illicit drug use, and HIV prevention.