1. Correlates of Adherence to Oral and Vaginal Pre-exposure Prophylaxis (PrEP) Among Adolescent Girls and Young Women (AGYW) Participating in the MTN-034/REACH Trial.
- Author
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Ngure, Kenneth, Browne, Erica N., Reddy, Krishnaveni, Friedland, Barbara A., van der Straten, Ariane, Palanee-Phillips, Thesla, Nakalega, Rita, Gati, Brenda, Kalule, Hadijah N., Siziba, Bekezela, Soto-Torres, Lydia, Nair, Gonasagrie, Garcia, Morgan, Celum, Connie, and Roberts, Sarah T.
- Subjects
PATIENT compliance ,STATISTICAL correlation ,SELF-evaluation ,RESEARCH funding ,ORAL drug administration ,RANDOMIZED controlled trials ,DESCRIPTIVE statistics ,PRE-exposure prophylaxis ,CROSSOVER trials ,RESEARCH ,DRUGS ,INTRAVAGINAL administration ,BIOMARKERS - Abstract
We evaluated correlates of adherence to PrEP, including daily oral tenofovir disoproxil fumarate in combination emtricitabine (oral FTC/TDF) and the monthly dapivirine ring (ring)among adolescent girls and young women (AGYW) in the MTN-034/REACH study. We enrolled 247 AGYW aged 16–21 years in South Africa, Uganda and Zimbabwe (ClinicalTrials.gov: NCT03074786). Participants were randomized to the order of oral FTC/TDF or ring use for 6 months each in a crossover period, followed by a 6-month choice period. We assessed potential adherence correlates—individual, interpersonal, community, study, and product-related factors—quarterly via self-report. We measured biomarkers of adherence monthly; high adherence was defined as > 4 mg dapivirine released from returned rings or intracellular tenofovir diphosphate levels ≥ 700 fmol/punch from dried blood spots (DBS). We tested associations between correlates and objective measures of high adherence using generalized estimating equations. High adherence to oral FTC/TDF was significantly associated with having an older primary partner (p = 0.04), not having exchanged sex in the past 3 months (p = 0.02), and rating oral FTC/TDF as highly acceptable (p = 0.003). High ring adherence was significantly associated with unstable housing (p = 0.01), disclosing ring use to a male family member (p = 0.01), and noting a social benefit from study participation (p = 0.03). All associations were moderate, corresponding to about 6%–10% difference in the proportion with high adherence. In our multinational study, correlates of adherence among African AGYW differed for oral FTC/TDF and the ring, highlighting the benefit of offering multiple PrEP options. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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