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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

Haberer JE, Baeten JM, Campbell J, et al. · PLoS medicine · 2013

doi.org/10.1371/journal.pmed.1001511Read the full paper ↗192 citationscc by

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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