Comparison of subjective and objective adherence measures for preexposure prophylaxis against HIV infection among serodiscordant couples in East Africa

AIDS
Nicholas MusinguziPartners PrEP Ancillary Adherence Study Team

Abstract

Preexposure prophylaxis (PrEP) efficacy is highly dependent on adherence. Yet, it is unclear which adherence measures perform best for PrEP. We compared three types of self-reported adherence questions (rating of ability to adhere, frequency of doses taken, percentage of doses taken) and three forms of objective adherence measurement [unannounced pill counts (UPC), electronic monitoring, plasma tenofovir levels] using data from an ancillary adherence study within a clinical trial of PrEP among East African serodiscordant couples (Partners PrEP Study). Monthly measures were assessed for the first 6 months of follow-up. One thousand, one hundred and forty-seven participants contributed 6048 person-months of data to this analysis. Median adherence was high: self-reported rating (90%), self-reported frequency (93%), and self-reported percentage (97%); UPC (99%); and electronic monitoring (97%). Prevalence of steady-state daily dosing (SSDD; ≥40 ng/ml) was 74% in a random subset of tenofovir samples obtained from 365 participants. Discrimination of SSDD versus less than SSDD levels was poor for self-reported rating [area under the receiver-operating curve (AROC) 0.54], self-reported frequency (AROC 0.52), self-reported percentage (A...Continue Reading

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Citations

Nov 2, 2017·AIDS and Behavior·Andrew AbaasaJessica E Haberer
Jul 20, 2019·Haemophilia : the Official Journal of the World Federation of Hemophilia·Vanessa Giroto GuedesEdison Iglesias de Oliveira Vidal
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