Year: 2017
Type: article
Abstract: Measuring PrEP adherence remains challenging. In 2009-2010, the International AIDS Vaccine Initiative randomized phase II trial participants to daily tenofovir disoproxil fumarate/emtricitabine or placebo in Uganda and Kenya. Adherence was measured by electronic monitoring (EM), self-report (SR), and drug concentrations in plasma and hair. Each adherence measure was categorised as low, moderate, or high and also considered continuously; the incremental value of combining measures was determined. Forty-five participants were followed over 4 months. Discrimination for EM adherence by area under receiver operating curves (AROC) was poor for SR (0.53) and best for hair (AROC 0.85). When combining hair with plasma or hair with self-report, discrimination was improved (AROC > 0.9). Self-reported adherence was of low utility by itself. Hair level was the single best PK measure to predict EM-assessed adherence; the other measurements had lower discrimination values. Combining short-term (plasma) and long-term (hair) metrics could be useful to assess patterns of drug-taking in the context of PrEP.
Source: AIDS and Behavior
Institutions: MRC/UVRI & LSHTM Uganda Research Unit, Uganda Virus Research Institute, Johns Hopkins University, Johns Hopkins Medicine, University of California, San Francisco, International AIDS Vaccine Initiative, Kenya Medical Research Institute, University of Oxford, University of Nairobi, Kenya AIDS Vaccine Initiative, Harvard University, Massachusetts General Hospital
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,590
Awards: G3726674119, G3936936596, G762740169, G97119092
OpenAlex ID: W2766092749