Context matters: PrEP adherence is associated with sexual behavior among HIV serodiscordant couples in East Africa
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Date
2017
Journal Title
Journal ISSN
Volume Title
Publisher
Journal of acquired immune deficiency syndromes
Abstract
Short message service (SMS) surveys are a promising tool for understanding whether pre-exposure prophylaxis (PrEP) adherence aligns with risk for HIV acquisition— a concept known as prevention-effective adherence.
Methods—The Partners Demonstration Project was an open-label study of integrated PrEP and antiretroviral therapy (ART) delivery among high-risk HIV serodiscordant couples in East Africa. HIV-uninfected partners were offered PrEP until their HIV-infected partner had taken ART for ≥6 months. At 2 study sites, HIV-uninfected partners were offered enrollment into the Partners Mobile Adherence to PrEP (PMAP) sub-study based on ongoing PrEP use, personal cell phone ownership, and ability to use SMS. SMS surveys asked about PrEP adherence and sexual activity in the prior 24 hours; these surveys were sent daily for the 7 days prior and 7 days after routine study visits in the Partners Demonstration Project.
Results—The PMAP sub-study enrolled 373 HIV-uninfected partners; 69% were male and mean age was 31 years. Participants completed 17,030 of 23,056 SMS surveys sent (74%) with a mean of 47 surveys per participant over 9.8 months of follow-up. While HIV-infected partner use of ART was <6 months, mean reported PrEP adherence was 92% on surveys concurrently reporting sex within the serodiscordant partnership and 84% on surveys reporting no sex (p<0.001).
Discussion—SMS surveys provided daily assessment of concurrent PrEP adherence and sexual behavior. Higher PrEP adherence was temporally associated with increased risk for HIV acquisition.
Description
Keywords
HIV, Pre-exposure prophylaxis (PrEP), SMS, Adherence
Citation
Haberer, J. E., Ngure, K., Muwonge, T., Mugo, N., Katabira, E., Heffron, R., ... & Baeten, J. M. (2017). Context matters: PrEP adherence is associated with sexual behavior among HIV serodiscordant couples in East Africa. Journal of acquired immune deficiency syndromes (1999), 76(5), 488. doi:10.1097/QAI. 0000000000001548.