Understanding Barriers to PrEP Adherence: A Brief Report on the Combined Effects of Alcohol Misuse, PTSD, and Gut Microbiome Disruption in HIV Prevention

Md Rakibul Hasan; Richard Davidson

doi:10.62377/ayk4kk55

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Published: 03-08-2025

DOI: https://doi.org/10.62377/ayk4kk55

Keywords:

PrEP adherence, alcohol misuse, PTSD, HIV Prevention, Gut dysbiosis

Dr. Md Rakibul Hasan

Graduate Research Assistant (GI Clinical Trial Unit) and Doctoral Student, University of Louisville, School of Public Health, United States

https://orcid.org/0000-0002-9152-8753

Richard Davidson

The State University of New York (SUNY), Buffalo, NY, United States

Abstract

Background: Human Immunodeficiency Virus (HIV) remains a global health challenge. While Pre-exposure Prophylaxis (PrEP) offers high efficacy for prevention, its adherence is significantly impacted by gastrointestinal (GI) dysbiosis and hazardous alcohol use. Alcohol misuse exacerbates PTSD and behavioral health issues, and chronic alcohol use can escalate GI disturbances, potentially leading to severe conditions like alcoholic hepatitis.

Methods: This brief report presents a conceptual analysis of existing literature and retrospective clinical data. Thematic coding was utilized to identify correlations between alcohol use, GI dysbiosis, PTSD, and PrEP adherence among HIV-negative individuals.

Results: Hazardous alcohol use amplifies PTSD symptoms and disrupts gut microbiota, causing systemic inflammation and broader behavioral problems. These factors collectively compromise PrEP adherence, with affected individuals demonstrating rates as low as 45–60%, particularly in marginalized groups.

Conclusion: Integrated behavioral interventions prioritizing alcohol reduction, microbiome support, and trauma-informed mental health care are crucial to optimize PrEP outcomes and advance HIV prevention efforts.

Issue

Vol. 2 No. 2 (2025)

Section

Review

This work is licensed under a Creative Commons Attribution 4.0 International License.

Author Biographies

Dr. Md Rakibul Hasan, Graduate Research Assistant (GI Clinical Trial Unit) and Doctoral Student, University of Louisville, School of Public Health, United States

Mr. Hasan is a medical doctor and public health researcher currently based in the United States. He earned his Bachelor of Medicine in Bangladesh and completed an MPH at Anglia Ruskin University in Cambridge, UK. He also holds a diploma in neuroscience from the European Neuroscience Academy and received training in emergency medicine from the University of Glasgow. Dr. Hasan has participated in clinical and academic training programs across Bangladesh, the UK, and the U.S., including the NHS in London.

He has practiced medicine in Dhaka and worked as a senior healthcare professional at Cambridge University Hospitals, as well as a teaching assistant at Cambridge Regional College. He began postgraduate studies in global health at the University of Ghent in Belgium.

Currently, Dr. Hasan is pursuing a PhD in Health Promotion and Behavioral Sciences at the University of Louisville, where he works as a Graduate Research Assistant in the GI Clinical Trials Unit on NIH-funded studies. His research focuses on HIV prevention, behavioral health, health disparities, and cancer prevention. He is also involved in international health research collaborations and serves as an Assistant Editor for a peer-reviewed medical journal in Bangladesh.

Richard Davidson, The State University of New York (SUNY), Buffalo, NY, United States

PhD Student and Research Assistant (School of Global Health), The University at Buffalo, New York, United States

How to Cite

Understanding Barriers to PrEP Adherence: A Brief Report on the Combined Effects of Alcohol Misuse, PTSD, and Gut Microbiome Disruption in HIV Prevention. (2025). Asian Journal of Public Health and Nursing, 2(2), 14-27. https://doi.org/10.62377/ayk4kk55