Publication Abstract Display | Type: Published Manuscript | Title: Predictors of long term HIV pre exposure prophylaxis adherence after study participation in men who have sex with men. | Authors: Hoenigl M, Hassan A, Moore DJ, Anderson PL, Corado K, Dube MP, Ellorin EE, Blumenthal J, Morris SR | Year: 2019 | Publication: Journal of Acquired Immune Deficiency Syndromes (1999) | Volume: 81 Issue: 2 Pages: 166-174 | Abstract:BACKGROUND:
Efficacy of HIV pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM) is well documented in randomized trials. Following trial completion, participants are challenged with acquiring PrEP on their own, and remaining adherent.
METHODS:
This was a follow-up study of the TAPIR randomized controlled multi-center PrEP trial. Participants were contacted after their last TAPIR visit (i.e., after study provided PrEP was discontinued) to attend observational post-trial visits 24 and 48 weeks later. Adherence during TAPIR and post-trial visits was estimated by dried blood spot (DBS) intracellular tenofovir diphosphate (TFV-DP) levels (adequate adherence defined as TFV-DP levels >719 fmol/punch). Binary logistic regression analysis assessed predictors of completing post-trial visits and PrEP adherence among participants completing ≥ 1 visit.
RESULTS:
Of 395 TAPIR participants who were on PrEP as part of the TAPIR trial for a median of 597 days (range 3-757 days), 122 (31%) completed ≥ 1 post-trial visit (57% of UCSD participants completed post-trial visits, while this was 13% or lower for other study sites). Among participants who completed ≥ 1 post-trial visit, 57% had adequate adherence post-trial. Significant predictors of adequate adherence post-trial were less problematic substance use, higher risk behavior, and adequate adherence in year 1 of TAPIR.
CONCLUSION:
More than half of PrEP users followed after trial completion had successfully acquired PrEP and showed adequate adherence. Additional adherence monitoring and interventions measures may be needed for those with low PrEP adherence and problematic substance use during the first year of trial. |
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