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Low Disclosure of PrEP Nonadherence and HIV-Risk Behaviors Associated With Poor HIV PrEP Adherence in the HPTN 067/ADAPT Study
- Source :
- J Acquir Immune Defic Syndr
- Publication Year :
- 2019
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2019.
-
Abstract
- We evaluated the relationship between 2 types of social relationships, ie, (1) external support for use of HIV pre-exposure prophylaxis (PrEP) and related study supplies and (2) participants' disclosure of PrEP use and condom use and HIV PrEP adherence among daily-dosing regimen participants in HIV Prevention Trials Network (HPTN) 067, an open-label trial of oral tenofovir (TFV) disoproxil fumarate (TDF) 300 mg/emtricitabine (FTC) 200 mg.Using HPTN 067 survey data, we developed scales examining (1) Low Perceived External Support for PrEP: low perceived support by others for PrEP use or perceived negative reactions to the pill case (scoring ranges from 0 to 2) and (2) Participant-Staff Disclosure Challenges Scale, which identifies challenges to sharing nonuse of PrEP or condoms to study staff (scoring ranges from 0 to 4); these scales are the primary independent variables. Adherence, the dependent variable, was determined using log-transformed plasma TFV concentrations. generalized estimating equation (GEE) linear regression was used to assess the association between both scales and adherence.Participants (n = 161) included HIV-uninfected women in South Africa, and men who have sex with men and transgender women, in Thailand and the United States. In multivariable analyses, higher scores in the Participant-Staff Disclosure Challenges Scale were significantly associated with lower PrEP adherence [exp(β) = 0.62, 95% CI: (0.46 to 0.84); P = 0.002] as were increased days since the last PrEP dose [exp(β) = 0.73, 95% CI: (0.65 to 0.83); P ≤ 0.001].Given the association with adherence, study staff-participant interactions and participants' disclosure of PrEP challenges may be worthwhile intervention targets for improving PrEP adherence in confirmatory studies.
- Subjects :
- Male
Human immunodeficiency virus (HIV)
HIV Infections
030312 virology
medicine.disease_cause
Social Networking
law.invention
Condoms
Sexual and Gender Minorities
South Africa
law
Surveys and Questionnaires
Emtricitabine
Pharmacology (medical)
Young adult
0303 health sciences
Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination
virus diseases
Middle Aged
Thailand
Infectious Diseases
Social relationship
Drug Therapy, Combination
Female
medicine.drug
Adult
medicine.medical_specialty
Anti-HIV Agents
Disclosure
Hiv risk
Article
Medication Adherence
Young Adult
03 medical and health sciences
Risk-Taking
Condom
medicine
Humans
Homosexuality, Male
Tenofovir
Acquired Immunodeficiency Syndrome
business.industry
United States
Directly Observed Therapy
Regimen
Family medicine
Pre-Exposure Prophylaxis
Risk taking
business
Subjects
Details
- ISSN :
- 15254135
- Volume :
- 82
- Database :
- OpenAIRE
- Journal :
- JAIDS Journal of Acquired Immune Deficiency Syndromes
- Accession number :
- edsair.doi.dedup.....2f9d24544175d2b8229c89db6fe9a517