Performance of Multiple Adherence Measures for Pre-exposure Prophylaxis (PrEP) Among Young Women in Kenya

Overview

Journal AIDS Behav

Specialty Infectious Diseases

Date 2023 Jun 23

PMID 37351684

Authors

Nicholas Musinguzi

Kenneth Ngure

Elizabeth A Bukusi

Nelly R Mugo

Jared M Baeten

Peter L Anderson

Jessica E Haberer

Affiliations

Soon will be listed here.

Abstract

Understanding PrEP adherence is key in the formulation of HIV prevention strategies; however, measurement of adherence can be challenging. We compared multiple adherence measures in a two-year study of young Kenyan women at high risk of HIV acquisition. Among 289 participants, concordance between electronic adherence monitoring (EAM) and tenofovir diphosphate (TFV-DP) in dried blood spots ranged from 57 to 72% depending on selected thresholds. Using area under the receiver operating curve, discrimination of quantifiable TFV-DP was high at 0.85 with EAM and low at 0.49-0.54 for multiple self-reported measures. Correlation between EAM and self-reported measures was low (r < 0.11) although correlation within self-reported measures was moderate (r > 0.69). These findings indicate that both TFV-DP and EAM are useful PrEP adherence tools. Adherence would benefit from better availability of less expensive versions of both measurement tools. Additionally, further research on TFV-DP thresholds is needed to inform interpretation and use in understanding PrEP adherence in this population.

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