1. Predictors of Daily Adherence to HIV Pre-exposure Prophylaxis in Gay/Bisexual Men in the PRELUDE Demonstration Project.
- Author
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Vaccher SJ, Marzinke MA, Templeton DJ, Haire BG, Ryder N, McNulty A, Foster R, Grulich AE, and Zablotska IB
- Subjects
- Adult, Bisexuality psychology, HIV Infections psychology, Homosexuality, Male psychology, Humans, Male, Medication Adherence psychology, Middle Aged, New South Wales, Sexual Behavior psychology, Bisexuality statistics & numerical data, HIV Infections prevention & control, Homosexuality, Male statistics & numerical data, Medication Adherence statistics & numerical data, Pre-Exposure Prophylaxis statistics & numerical data
- Abstract
Adequate adherence to pre-exposure prophylaxis (PrEP) is critical to prevent HIV infection, but accurately measuring adherence remains challenging. We compared two biological [blood drug concentrations in plasma and peripheral blood mononuclear cells (PBMC)] and two self-reported measures (facilitated recall to clinicians and self-report in online surveys) and identified predictors of daily PrEP adherence among gay and bisexual men (GBM) in their first 12 months on PRELUDE, an open-label, single-arm PrEP demonstration project in New South Wales, Australia. 327 participants were enrolled; 263 GBM attended their 12-month follow-up visit (81% retention). Overall, 91% of blood samples had plasma drug concentrations indicative of taking 7 pills/week, and 99% had protective drug concentrations (≥ 4 pills/week). Facilitated recall to clinicians identified 99% of participants with protective adherence as measured by PBMC drug concentrations. Daily adherence measured by facilitated recall was associated with behavioural practices including group sex (aOR 1.33, 95% CI 1.15-1.53, p < 0.001). Retained participants maintained high adherence to daily PrEP over 12 months, confirmed by four different measures. Facilitated recall to clinicians is a suitable measure for assessing PrEP adherence in populations engaged in care where there is established trust and rapport with patients. Trial registration: ClinicalTrials.gov NCT02206555.
- Published
- 2019
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