Predictors of Daily Adherence to HIV Pre-exposure Prophylaxis in Gay/Bisexual Men in the PRELUDE Demonstration Project Academic Article uri icon

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.

authors

  • Vaccher, SJ
  • Marzinke, MA
  • Templeton, DJ
  • Haire, BG
  • Ryder, N
  • McNulty, A
  • Foster, R
  • Grulich, AE
  • Zablotska, IB
  • Bloch, M
  • Carr, A
  • Cheung, C
  • Gianacas, C
  • Grulich, A
  • Guy, R
  • Holt, M
  • Kaldor, J
  • Mackie, B
  • Mayer, K
  • McAllister, J
  • Murphy, D
  • Ooi, C
  • Pell, C
  • Poynten, IM
  • Prestage, G
  • Templeton, D
  • Vaccher, S
  • de Wit, J
  • Wright, E
  • Zablotska, I
  • Callander, D
  • Cooper, D
  • Cooper, C
  • Crooks, L
  • Duck, T
  • Grulich, A
  • Guy, R
  • Holden, J
  • Holt, M
  • Kaldor, J
  • Keen, P
  • Kelleher, A
  • Mitchell, J
  • Prestage, Garrett
  • Price, K
  • Selvey, C
  • Schmidt, HM
  • Telfer, B
  • Whittaker, B
  • Wilson, D
  • de Wit, J
  • Zablotska, I

publication date

  • 2019