Comparison of subjective and objective adherence measures for preexposure prophylaxis against HIV infection among serodiscordant couples in East Africa.

摘要: Background Preexposure prophylaxis (PrEP) efficacy is highly dependent on adherence. Yet, it unclear which adherence measures perform best for PrEP. Methods We compared three types of self-reported questions (rating ability to adhere, frequency doses taken, percentage taken) and forms objective measurement [unannounced pill counts (UPC), electronic monitoring, plasma tenofovir levels] using data from an ancillary study within a clinical trial PrEP among East African serodiscordant couples (Partners Study). Monthly were assessed the first 6 months follow-up. Results One thousand, one hundred forty-seven participants contributed 6048 person-months this analysis. Median was high: rating (90%), (93%), (97%); UPC (99%); monitoring (97%). Prevalence steady-state daily dosing (SSDD; ≥40 ng/ml) 74% in random subset samples obtained 365 participants. Discrimination SSDD versus less than levels poor [area under receiver-operating curve (AROC) 0.54], (AROC 0.52), 0.56) 0.58), but moderate 0.70). Correlation measures, (0.61-0.66), low these with (0.32-0.36) (0.22-0.28). Conclusion Electronic only measure meaningful discriminate between levels. subjective poor. Future research should explore novel approaches as moves into demonstration projects programmatic implementation.