Journal of acquired immune deficiency syndromes (1999) · 2026
Associations between self-reported PrEP use and short and long-term pharmacologic metrics of PrEP adherence among Kenyan women.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Velloza Jennifer, Adler Aliza, Chakravarty Deepalika, Glidden David V, Maina Gakuo, Biwott Charlene, Kiptinness Catherine, Spinelli Matthew A, Okochi Hideaki, Chatterjee Purba, Mugo Nelly, Ngure Kenneth, Gandhi Monica
Аннотация
BACKGROUND: Biomarkers provide reliable information on oral PrEP pill-taking. It remains unclear whether self-reported PrEP adherence has value when used in combination with pharmacologic measures. We examined associations between self-reported and biomarker-based PrEP adherence metrics to improve identification of those with low adherence in resource-constrained settings.
METHODS: HIV-uninfected women using oral tenofovir (TFV)-based PrEP were enrolled (N=100) in the Point-of-Care Urine Monitoring for Adherence trial in Kenya from 2021-2022. Participants were randomized 1:1 to standard-of-care or urine-based-point-of-care assay-informed drug-level feedback. Adherence was measured at enrollment and quarterly through 12 months via urine, hair and self-report. A positive urine assay (TFV≥1500 ng/mL) indicated short-term adherence. TFV hair concentration≥0.023 ng/mg indicated long-term adherence (4-times-weekly dosing). Self-reported adherence was calculated as the mean score (range=0-100) on a 2-item scale. Generalized estimating equations estimated longitudinal associations between self-reported adherence and biomarkers. Receiver-operating-characteristic curves assessed self-report as a predictor of biomarker metrics.
RESULTS: At enrollment, 68.7% had a positive urine assay, 83.7% had detectable hair TFV, and median self-reported adherence was 100 (IQR=90-100). At Month 12, participants with higher adherence scores were more likely to have hair TFV concentrations≥0.023 ng/mg (aRR=1.44; 95% CI=1.20-1.72; p-value<0.001) and positive urine results (aRR=1.56; CI=1.43-1.69; p-value=<0.001). Areas-under-the-curve for self-report as a predictor of hair levels were 0.64 in a model with self-report and 0.74 in a model with both self-report and urine testing.
CONCLUSIONS: Associations between self-reported and biomarker-verified PrEP adherence demonstrated accurate reporting. Incorporating biomarkers in studies may result in improved adherence and/or improved accuracy of self-report.
METHODS: HIV-uninfected women using oral tenofovir (TFV)-based PrEP were enrolled (N=100) in the Point-of-Care Urine Monitoring for Adherence trial in Kenya from 2021-2022. Participants were randomized 1:1 to standard-of-care or urine-based-point-of-care assay-informed drug-level feedback. Adherence was measured at enrollment and quarterly through 12 months via urine, hair and self-report. A positive urine assay (TFV≥1500 ng/mL) indicated short-term adherence. TFV hair concentration≥0.023 ng/mg indicated long-term adherence (4-times-weekly dosing). Self-reported adherence was calculated as the mean score (range=0-100) on a 2-item scale. Generalized estimating equations estimated longitudinal associations between self-reported adherence and biomarkers. Receiver-operating-characteristic curves assessed self-report as a predictor of biomarker metrics.
RESULTS: At enrollment, 68.7% had a positive urine assay, 83.7% had detectable hair TFV, and median self-reported adherence was 100 (IQR=90-100). At Month 12, participants with higher adherence scores were more likely to have hair TFV concentrations≥0.023 ng/mg (aRR=1.44; 95% CI=1.20-1.72; p-value<0.001) and positive urine results (aRR=1.56; CI=1.43-1.69; p-value=<0.001). Areas-under-the-curve for self-report as a predictor of hair levels were 0.64 in a model with self-report and 0.74 in a model with both self-report and urine testing.
CONCLUSIONS: Associations between self-reported and biomarker-verified PrEP adherence demonstrated accurate reporting. Incorporating biomarkers in studies may result in improved adherence and/or improved accuracy of self-report.