Abstract :
Introduction: Human Immunodeficiency Virus (HIV) remains a global health problem, especially in high-risk groups of men who have sex with men (MSM). Pre-Exposure Prophylaxis (PrEP) is an effective HIV prevention strategy, but its success is highly dependent on the level of adherence to use.
Objective: This study aims to analyse the effect of education and motivation on non-adherence to PrEP use in men who have sex with men in Kemiling District, Bandar Lampung, Indonesia.
Methods: This study used an observational analytical design with a cross-sectional approach conducted in January–February 2026 with a sample of 64 respondents selected using proportional random sampling. Data were collected through a structured questionnaire, with non-adherence measured using the MMAS-8, and analysed using the Chi-Square test.
Results: The results showed that education (p=0.016; OR=4.427; 95% CI: 1.441–13.602) and motivation (p=0.003; OR=6.240; 95% CI: 1.923–20.248) significantly influenced non-adherence to PrEP use. Respondents with higher education and good motivation tended to be more adherent compared to respondents with lower education and less motivation.
Conclusion: It can be concluded that education and motivation are important factors influencing non-adherence to PrEP use. Therefore, interventions that emphasize increasing health literacy and strengthening motivation through ongoing education and counselling are needed to improve PrEP adherence in the MSM population.
Keywords :
Education, HIV, Motivation, non-adherence, PrEP.References :
- Doe, J., & Miller, A. (2021). Virology of HIV and AIDS Treatment Strategies. Academic Health Press.
- Bandar Lampung Municipality Health Office. (2024). Report on the Development of HIV/AIDS Cases in Bandar Lampung City in 2024.
- Lampung Provincial Health Office. (2024). Lampung Province Health Profile 2024.
- Fauk, N. K., Mwanri, L., Hawke, K., & Ward, P. R. (2022). Understanding social and environmental factors contributing to HIV transmission in Indonesia. MedRxiv.
- Golub, S. A., & Gamarel, K. E. (2013). The impact of anticipated HIV stigma on delays in HIV testing behaviors. AIDS Patient Care and STDs, 27(11), 621–627.
- Goujard, C. M., Bernard, N. M., Sohier, N. M., et al. (2023). Impact of a patient education program on adherence to HIV medication: A randomized clinical trial. JAIDS Journal of Acquired Immune Deficiency Syndromes.
- Green, L. (2005). Health Program Planning, Implementation, and Evaluation.
- Hudrudchai, S., Suwanwong, C., Prasittichok, P., Mohan, K. P., & Janeaim, N. (2024). Pre-exposure prophylaxis adherence among men who have sex with men: A systematic review.
- Kementerian Kesehatan RI. (2018). Pengendalian dan Pencegahan Penyakit.
- Mimiaga, M. J., Case, P., Johnson, C. V., Safren, S. A., & Mayer, K. H. (2009). Pre-exposure antiretroviral prophylaxis attitudes in high-risk MSM. Journal of Acquired Immune Deficiency Syndromes, 50(1), 77–83.
- Morisky, D. E., Ang, A., Krousel-Wood, M., & Ward, H. J. (2008). Predictive validity of a medication adherence measure. Journal of Clinical Hypertension.
- Mueses-Marín, H. F., et al. (2021). Scales to assess knowledge, motivation, and self-efficacy for HIV PrEP use.
- Nursalam, & Diah, N. K. (2007). Asuhan Keperawatan pada Pasien Terinfeksi HIV/AIDS. Salemba Medika.
- Septiani, T. R., Hapsari, E. D., & Wibowo, Y. (2023). Determinants of PrEP adherence among MSM in urban Indonesia. International Journal of STD & AIDS, 34(1), 23–30.
- Sucerni, Sudirman, & Afni, N. (2023). Hubungan informasi dan motivasi dengan ketidakpatuhan minum obat ARV pada pasien HIV/AIDS.
- (2023). Global HIV & AIDS Statistics.
- (2024). Global HIV & AIDS Update.
- (2025). Asia-Pacific HIV Report.
- World Health Organization. (2024). Global HIV Progress Report 2024.
- Xin, Z., & Sun, J. (2020). Operator cognitive fatigue in industrial control tasks. Sensors.

