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43, 48 Other potential barriers to prescribing include concerns about cost, safety, efficacy, risk compensation, adherence, time commitment, and a lack of guidelines.
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Southern countries will find the economic compensation for their adherence to the European idea too meagre and the supervision attached to it too intrusive, and northern countries will find the financial demands of their southern partners excessive and the control offered them in return ineffective.
But imposing restrictive content and financial compensation restrictions on adherence programs does nothing to improve privacy and punishes patients, particularly seniors and those with chronic illness and many others who benefit from timely medication reminders.
In the last year, a population level behaviour change intervention was found to be ineffective [15] and risk compensation and low adherence may have contributed to no effect being found in trials to prevent HIV infection through diaphragm use [16] and herpes treatment [17], respectively.
In particular, it will be important to test interventions that could be coupled with PrEP to minimize risk compensation and maximize adherence in the setting of known efficacy and implementation outside of clinical trials.
Participants were compensated for completing baseline and postintervention assessments, with additional compensation based on intervention adherence.
The higher amount of xanthan produced by this mutant may be explained by a mechanism of compensation for the lack of adherence, though it is not enough by itself to promote the formation of the biofilm, suggesting that the xanthan required for biofilm formation may be maintained in the extracellular matrix in an adhesin-dependent manner.
Our research identifies the need to consider acceptability factors which extend beyond drug adherence and risk compensation when introducing and scaling up PrEP and has a number of implications for policy and clinical practice.
Similar to adherence, most information on risk compensation comes from RCTs.
The two cases demonstrate that the principle of reciprocity receives little attention, which is surprising because reciprocity should be considered not only as compensation but also as an assurance of adherence, and subsequently an element of effectiveness.
Limited data exist on issues pertaining to risk compensation behavior and the capacity for non-adherence or early initiation to lead to drug resistance (despite many of the ethical arguments being premised on this concern) [ 51].
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com