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Utility of Different Adherence Measures for PrEP: Patterns and Incremental Value

Measuring PrEP adherence remains challenging. In 2009–2010, the International AIDS Vaccine Initiative randomized phase II trial participants to daily tenofovir disoproxil fumarate/emtricitabine or placebo in Uganda and Kenya. Adherence was measured by electronic monitoring (EM), self-report (SR), an...

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Autores principales: Abaasa, Andrew, Hendrix, Craig, Gandhi, Monica, Anderson, Peter, Kamali, Anatoli, Kibengo, Freddie, Sanders, Eduard J., Mutua, Gaudensia, Bumpus, Namandjé N., Priddy, Frances, Haberer, Jessica E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5878836/
https://www.ncbi.nlm.nih.gov/pubmed/29090394
http://dx.doi.org/10.1007/s10461-017-1951-y
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author Abaasa, Andrew
Hendrix, Craig
Gandhi, Monica
Anderson, Peter
Kamali, Anatoli
Kibengo, Freddie
Sanders, Eduard J.
Mutua, Gaudensia
Bumpus, Namandjé N.
Priddy, Frances
Haberer, Jessica E.
author_facet Abaasa, Andrew
Hendrix, Craig
Gandhi, Monica
Anderson, Peter
Kamali, Anatoli
Kibengo, Freddie
Sanders, Eduard J.
Mutua, Gaudensia
Bumpus, Namandjé N.
Priddy, Frances
Haberer, Jessica E.
author_sort Abaasa, Andrew
collection PubMed
description Measuring PrEP adherence remains challenging. In 2009–2010, the International AIDS Vaccine Initiative randomized phase II trial participants to daily tenofovir disoproxil fumarate/emtricitabine or placebo in Uganda and Kenya. Adherence was measured by electronic monitoring (EM), self-report (SR), and drug concentrations in plasma and hair. Each adherence measure was categorised as low, moderate, or high and also considered continuously; the incremental value of combining measures was determined. Forty-five participants were followed over 4 months. Discrimination for EM adherence by area under receiver operating curves (AROC) was poor for SR (0.53) and best for hair (AROC 0.85). When combining hair with plasma or hair with self-report, discrimination was improved (AROC > 0.9). Self-reported adherence was of low utility by itself. Hair level was the single best PK measure to predict EM-assessed adherence; the other measurements had lower discrimination values. Combining short-term (plasma) and long-term (hair) metrics could be useful to assess patterns of drug-taking in the context of PrEP.
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spelling pubmed-58788362018-04-04 Utility of Different Adherence Measures for PrEP: Patterns and Incremental Value Abaasa, Andrew Hendrix, Craig Gandhi, Monica Anderson, Peter Kamali, Anatoli Kibengo, Freddie Sanders, Eduard J. Mutua, Gaudensia Bumpus, Namandjé N. Priddy, Frances Haberer, Jessica E. AIDS Behav Original Paper Measuring PrEP adherence remains challenging. In 2009–2010, the International AIDS Vaccine Initiative randomized phase II trial participants to daily tenofovir disoproxil fumarate/emtricitabine or placebo in Uganda and Kenya. Adherence was measured by electronic monitoring (EM), self-report (SR), and drug concentrations in plasma and hair. Each adherence measure was categorised as low, moderate, or high and also considered continuously; the incremental value of combining measures was determined. Forty-five participants were followed over 4 months. Discrimination for EM adherence by area under receiver operating curves (AROC) was poor for SR (0.53) and best for hair (AROC 0.85). When combining hair with plasma or hair with self-report, discrimination was improved (AROC > 0.9). Self-reported adherence was of low utility by itself. Hair level was the single best PK measure to predict EM-assessed adherence; the other measurements had lower discrimination values. Combining short-term (plasma) and long-term (hair) metrics could be useful to assess patterns of drug-taking in the context of PrEP. Springer US 2017-10-31 2018 /pmc/articles/PMC5878836/ /pubmed/29090394 http://dx.doi.org/10.1007/s10461-017-1951-y Text en © The Author(s) 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Paper
Abaasa, Andrew
Hendrix, Craig
Gandhi, Monica
Anderson, Peter
Kamali, Anatoli
Kibengo, Freddie
Sanders, Eduard J.
Mutua, Gaudensia
Bumpus, Namandjé N.
Priddy, Frances
Haberer, Jessica E.
Utility of Different Adherence Measures for PrEP: Patterns and Incremental Value
title Utility of Different Adherence Measures for PrEP: Patterns and Incremental Value
title_full Utility of Different Adherence Measures for PrEP: Patterns and Incremental Value
title_fullStr Utility of Different Adherence Measures for PrEP: Patterns and Incremental Value
title_full_unstemmed Utility of Different Adherence Measures for PrEP: Patterns and Incremental Value
title_short Utility of Different Adherence Measures for PrEP: Patterns and Incremental Value
title_sort utility of different adherence measures for prep: patterns and incremental value
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5878836/
https://www.ncbi.nlm.nih.gov/pubmed/29090394
http://dx.doi.org/10.1007/s10461-017-1951-y
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