Perceptions of Daily and On-Demand HIV Pre-Exposure Prophylaxis and Digital Adherence-Support Needs Among Cisgender Men in Brazil: Qualitative Interview and Focus Group Study

Findings highlight clear generational differences in how cisgender men perceive daily and on-demand PrEP. Older participants draw on memories of the early AIDS crisis, whereas younger men situate PrEP within app-mediated sexual cultures. Importantly, they agree that the on-demand regimen requires not only greater discipline but also a learning process to incorporate and normalize its episodic dosing into everyday life. The positive reception toward a digital adherence support tool demonstrates potential public health value in such technologies, provided privacy and data security concerns are effectively addressed. Efforts to improve adherence and expand access to on-demand PrEP could significantly benefit from incorporating user-driven insights into digital tool development.