Comparison of Measures of Adherence to Human Immunodeficiency Virus Preexposure Prophylaxis Among Adolescent and Young Men Who Have Sex With Men in the United States

Young men-who-have-sex-with-men (MSM) are disproportionately impacted by human immunodeficiency virus (HIV). Preexposure prophylaxis (PrEP) could reduce HIV acquisition among youth, but suboptimal adherence threatens effectiveness. Optimal metrics of PrEP adherence among adolescents have remain unde...

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Bibliographic Details
Published in:Clinical infectious diseases 2018-01, Vol.66 (2), p.213-219
Main Authors: Koss, Catherine A, Hosek, Sybil G, Bacchetti, Peter, Anderson, Peter L, Liu, Albert Y, Horng, Howard, Benet, Leslie Z, Kuncze, Karen, Louie, Alexander, Saberi, Parya, Wilson, Craig M, Gandhi, Monica
Format: Article
Language:English
Subjects:
Adolescent
and Commentaries
Anti-HIV Agents - administration & dosage
Anti-HIV Agents - analysis
Aspergillosis
Blood Chemical Analysis
Chronic obstructive pulmonary disease
Disease Transmission, Infectious - prevention & control
Emtricitabine - administration & dosage
Emtricitabine - analysis
Enzyme-linked immunosorbent assay
Gene frequency
Gene sequencing
Genotypes
Hair - chemistry
Haplotypes
HIV
HIV Infections - prevention & control
HIV Infections - transmission
Homosexuality, Male
Human immunodeficiency virus
Humans
Lung diseases
Male
Medical diagnosis
Medication Adherence - statistics & numerical data
Obstructive lung disease
Patients
Pentraxins
Polymerase chain reaction
Pre-Exposure Prophylaxis - methods
Pre-Exposure Prophylaxis - statistics & numerical data
Prophylaxis
Risk
Single-nucleotide polymorphism
Studies
Tenofovir - administration & dosage
Tenofovir - analysis
Transplantation
Transplants & implants
United States
Viruses
Young Adult
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Summary:Young men-who-have-sex-with-men (MSM) are disproportionately impacted by human immunodeficiency virus (HIV). Preexposure prophylaxis (PrEP) could reduce HIV acquisition among youth, but suboptimal adherence threatens effectiveness. Optimal metrics of PrEP adherence among adolescents have remain undefined. The Adolescent Trials Network 110/113 studies provided daily oral PrEP with tenofovir (TFV) disoproxil fumarate/emtricitabine over 48 weeks to a diverse population of MSM (aged 15-22 years). Self-reported adherence was assessed and PrEP drug concentrations measured from hair and dried blood spot (DBS) samples; 23% of participants received Wisepill electronic monitoring devices. The average number of PrEP doses per week taken was estimated, and concordance between measures assessed. Among 243 participants, hair samples were collected at 1186/1238 (96%) person-visits. The concordance of TFV levels in hair and TFV-diphosphate in DBS around thresholds consistent with taking ≥4 and 7 PrEP doses/week was high (76% and 80%). Hair and DBS concentrations correlated poorly with self-report and Wisepill metrics. Through week 12, 40%-60% of participants (by hair and DBS), ≤31% (Wisepill), and >85% (self-report) were estimated to have taken ≥4 PrEP doses/week (a threshold associated with protection among MSM). For all measures except self-report, adherence declined over time, with half of participants taking
ISSN:1058-4838
1537-6591
DOI:10.1093/cid/cix755