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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
An intervention to support HIV preexposure prophylaxis adherence in HIV-serodiscordant couples in Uganda
Journal of Acquired Immune Deficiency Syndromes, Volume 66, No. 5, Year 2014
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Description
BACKGROUND: Daily preexposure prophylaxis (PrEP) is an effective HIV prevention strategy, but adherence is required for maximum benefit. To date, there are no empirically supported PrEP adherence interventions. This article describes the process of developing a PrEP adherence intervention and presents results on its impact on adherence. METHODS: The Partners PrEP Study was a placebo-controlled efficacy trial of daily oral tenofovir and emtricitabine/tenofovir PrEP among uninfected members of HIV-serodiscordant couples. An ancillary adherence study was conducted at 3 study sites in Uganda. Participants with <80% adherence as measured by unannounced pill count received an additional adherence counseling intervention based on Lifesteps, an evidence-based HIV treatment adherence intervention, based on principles of cognitive-behavioral theory. FINDINGS: Of the 1147 HIV-seronegative participants enrolled in the ancillary adherence study, 168 (14.6%) triggered the adherence intervention. Of participants triggering the intervention, 62% were men; median age was 32.5 years. The median number of adherence counseling sessions was 10. Mean adherence during the month before the intervention was 75.7% and increased significantly to 84.1% in the month after the first intervention session (P < 0.001). The most frequently endorsed adherence barriers at session 1 were travel and forgetting. INTERPRETATION: A PrEP adherence intervention was feasible in a clinical trial of PrEP in Uganda and PrEP adherence increased after the intervention. Future research should identify PrEP users with low adherence for enhanced adherence counseling and determine optimal implementation strategies for interventions to maximize PrEP effectiveness. Copyright © 2014 by Lippincott Williams & Wilkins.
Authors & Co-Authors
Psaros, Christina
United States, Boston
Massachusetts General Hospital
United States, Boston
Harvard Medical School
Haberer, Jessica Elizabeth
United States, Boston
Harvard Medical School
United States, Boston
Massachusetts General Hospital
Katabira, Elly Tebasoboke
Uganda, Kampala
Makerere University
Ronald, Allan R.
Canada, Winnipeg
University of Manitoba
Tumwesigye, Elioda
Uganda
Kabwohe Clinical Research Center
Campbell, James D.
United States, Atlanta
Centers for Disease Control and Prevention
Wangisi, Jonathan
United States, Atlanta
Centers for Disease Control and Prevention
Mugwanya, Kenneth K.
United States, Seattle
University of Washington
Kintu, Alexander
Uganda
Kabwohe Clinical Research Center
United States, Boston
Harvard T.h. Chan School of Public Health
Enyakoit, Michael
Uganda, Kampala
Makerere University College of Health Sciences
Thomas, Katherine K.
United States, Seattle
University of Washington
Donnell, Deborah J.
United States, Seattle
University of Washington
United States, Seattle
Fred Hutchinson Cancer Research Center
Krows, Meighan L.
United States, Seattle
University of Washington
Kidoguchi, Lara
United States, Seattle
University of Washington
Ware, Norma C.
United States, Boston
Harvard Medical School
Baeten, Jared M.
United States, Seattle
University of Washington
Celum, Connie L.
United States, Seattle
University of Washington
Bangsberg, David R.
United States, Boston
Massachusetts General Hospital
United States, Boston
Harvard Medical School
Uganda, Kampala
Makerere University College of Health Sciences
Uganda, Mbarara
Mbarara University of Science and Technology
Safren, Steven A.
United States, Boston
Massachusetts General Hospital
United States, Boston
Harvard Medical School
Statistics
Citations: 54
Authors: 19
Affiliations: 11
Identifiers
Doi:
10.1097/QAI.0000000000000212
ISSN:
15254135
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Randomised Control Trial
Study Locations
Uganda
Participants Gender
Male