Identifying Hidden Barriers to PrEP Adherence Among Young Men Who Have Sex with Men: Application of Natural Language Processing.

In the United States, the incidence rate of new HIV diagnoses continues to increase among young men who have sex with men (YMSM). Despite the availability of effective preventive strategies such as pre-exposure prophylaxis (PrEP), the rate of PrEP adherence remains markedly low especially among YMSM...

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Publicado en:AIDS & Behavior Vol. 30; no. 1; pp. 253 - 263
Autores principales: Min, Se Hee, Scroggins, Jihye Kim, Duncan, Dustin T., Garofalo, Robert, Janulis, Patrick Francis, Kuhns, Lisa, Xiao, Fengdi, Schnall, Rebecca
Formato: research tables/charts Journal Article
Publicado: Springer Nature Jan2026
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Identifying Hidden Barriers to PrEP Adherence Among Young Men Who Have Sex with Men: Application of Natural Language Processing.
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        au:
          Min, Se Hee
          Scroggins, Jihye Kim
          Duncan, Dustin T.
          Garofalo, Robert
          Janulis, Patrick Francis
          Kuhns, Lisa
          Xiao, Fengdi
          Schnall, Rebecca
        affil: https://ror.org/00b30xv10 University of Pennsylvania School of Nursing, 418 Curie Blvd, 19104, Philadelphia, PA, USA
      sug:
        subj:
          HIV Infections Prevention and Control
          Pre-Exposure Prophylaxis
          Medication Compliance
          Men Who Have Sex With Men Psychosocial Factors
          Natural Language Processing
          Healthcare Disparities
          Human
          Male
          Adult
          United States
          Secondary Analysis
          Prospective Studies
          Risk Assessment
          Insurance, Health
          Social Determinants of Health
          Patient Dropouts
          Machine Learning
          Support Vector Machine
          Random Forest
          Thematic Analysis
          ROC Curve
          Statistical Significance
          Data Analysis Software
          Descriptive Statistics
          Funding Source
          Adult: 19-44 years
          Male
      ab: In the United States, the incidence rate of new HIV diagnoses continues to increase among young men who have sex with men (YMSM). Despite the availability of effective preventive strategies such as pre-exposure prophylaxis (PrEP), the rate of PrEP adherence remains markedly low especially among YMSM. Previous studies have primarily relied on structured surveys with predefined responses to identify barriers to PrEP adherence which may not fully capture the complexities behind the barriers. This is a secondary data analysis of data from a prospective cohort study focusing on YMSM vulnerable to HIV. A total of 581 participants provided free-text responses regarding reasons for discontinuing PrEP, which served as the primary outcome for the analysis. Natural language processing was conducted to identify potential barriers to PreP adherence and to uncover any previously unidentified barriers in this population. A total of nine categories were identified, with the most prevalent being lack of sexual activity (n = 128), followed by issues related to monogamy/partnership/long-term relationship (n = 73), specific insurance or coverage issues (n = 52), medication-related concerns (n = 41), side effects/health concerns (n = 39), forgetfulness/inconvenience associated with the medication regimen (n = 33), limited healthcare access (n = 26), personal reasons (n = 9), and financial insecurity (n = 8). The NLP analysis demonstrated moderate performance via support vector machine, random forest, gradient boost, and random forest (F-score = 0.75). Our study provides critical insights into specific barriers faced by high-risk YMSM, emphasizing the need for development of targeted interventions aimed at these barriers to improve PrEP access and utilization.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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