PrEP adherence in Partners PrEP
In a Partners PrEP adherence substudy, median pill-count and MEMS adherence exceeded 97%, and counseling restored most low adherers to ≥80%.
Source
Adherence to antiretroviral prophylaxis for HIV prevention: a substudy cohort within a clinical trial of serodiscordant couples in East Africa
Study at a glance
- Design
- Cohort — Partners PrEP adherence substudy with UPC, MEMS, and stepped counseling
- N
- N=1147 · HIV-uninfected partners at three East African sites
- Population
- HIV-uninfected partners in serodiscordant couples on PrEP within a clinical trial
- Outcome
- Pill-count and MEMS adherence, and return to ≥80% after counseling
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PrEP adherence in Partners PrEP
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1,147 participants enrolled in the adherence substudy.
1,147 participants were enrolled in the study, reflecting 66% of all participants in the three study sites.
Median adherence 99.1% by UPC and 97.2% by MEMS.
Median overall participant adherence was 99.1% (IQR 96.9%–100%) by UPC and 97.2% (IQR 90.6%–100%) by MEMS.
What they did
At three Partners PrEP sites, 1,147 HIV-uninfected partners received unannounced pill counts (UPC) and MEMS monitoring plus stepped adherence counseling when UPC fell below 80%.
What they found
Median adherence 99.1% (UPC) and 97.2% (MEMS); few had sustained low UPC adherence; among those triggered, 92% returned to ≥80% UPC after intervention sessions.
The limits
What it doesn't show
High adherence in a trial with intensive monitoring may not equal routine clinic PrEP adherence.
Key terms
- PrEP
- Pre-exposure prophylaxis with antiretroviral drugs to prevent HIV.
- UPC
- Unannounced home-based pill counts measuring leftover doses.
- MEMS
- Medication Event Monitoring System bottle-cap openings.
- Partners PrEP
- Phase III RCT of TDF/FTC-TDF among serodiscordant couples.
- Adherence counseling
- Stepped behavioral support when adherence fell below 80%.
- Serodiscordant couple
- Partnership with one HIV-infected and one HIV-uninfected partner.
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UPC means?
Common questions
Substudy N?
1,147 participants (66% of those sites’ trial participants).
Median adherence?
99.1% by UPC and 97.2% by MEMS.
Low-adherence trigger?
UPC <80% prompted intensified counseling.
Counseling effect?
92% of triggered participants improved to ≥80% UPC.
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