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Patterns and correlates of PrEP drug detection among MSM and transgender women in the Global iPrEx Study.
- Source :
-
Journal of acquired immune deficiency syndromes (1999) [J Acquir Immune Defic Syndr] 2014 Dec 15; Vol. 67 (5), pp. 528-37. - Publication Year :
- 2014
-
Abstract
- Background: Adherence to pre-exposure prophylaxis (PrEP) is critical for efficacy. Antiretroviral concentrations are an objective measure of PrEP use and correlate with efficacy. Understanding patterns and correlates of drug detection can identify populations at risk for nonadherence and inform design of PrEP adherence interventions.<br />Methods: Blood antiretroviral concentrations were assessed among active arm participants in iPrEx, a randomized placebo-controlled trial of emtricitabine/tenofovir in men who have sex with men and transgender women in 6 countries. We evaluated rates and correlates of drug detection among a random sample of 470 participants at week 8 and a longitudinal cohort of 303 participants through 72 weeks of follow-up.<br />Results: Overall, 55% of participants (95% confidence interval: 49 to 60) tested at week 8 had drug detected. Drug detection was associated with older age and varied by study site. In longitudinal analysis, 31% never had drug detected, 30% always had drug detected, and 39% had an inconsistent pattern. Overall detection rates declined over time. Drug detection at some or all visits was associated with older age, indices of sexual risk, including condomless receptive anal sex, and responding "don't know" to a question about belief of PrEP efficacy (0-10 scale).<br />Conclusions: Distinct patterns of study product use were identified, with a significant proportion demonstrating no drug detection at any visit. Research literacy may explain greater drug detection among populations having greater research experience, such as older men who have sex with men in the United States. Greater drug detection among those reporting highest risk sexual practices is expected to increase the impact and cost-effectiveness of PrEP.
- Subjects :
- Adolescent
Adult
Anti-Retroviral Agents analysis
Blood Chemical Analysis
Drug Utilization
Female
Humans
Male
Medication Adherence
Middle Aged
United States
Young Adult
Anti-Retroviral Agents therapeutic use
Chemoprevention statistics & numerical data
Disease Transmission, Infectious prevention & control
HIV Infections prevention & control
Homosexuality, Male
Pre-Exposure Prophylaxis statistics & numerical data
Transgender Persons
Subjects
Details
- Language :
- English
- ISSN :
- 1944-7884
- Volume :
- 67
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Journal of acquired immune deficiency syndromes (1999)
- Publication Type :
- Academic Journal
- Accession number :
- 25230290
- Full Text :
- https://doi.org/10.1097/QAI.0000000000000351