title: Self-reported Recent PrEP Dosing and Drug Detection in an Open Label PrEP Study.
abstract: Monitoring adherence to pre-exposure prophylaxis (PrEP) is part of the recommended package for PrEP prescribing, yet ongoing concerns about how to do so confidently are exacerbated by gross discrepancies in reported and actual use in clinical trials. We evaluated concordance between reports of recent PrEP dosing collected via neutral interviewing and drug quantitation in the iPrEx open-label extension, where participants (n = 1172) had the choice to receive or not receive PrEP. Self-report of recent dosing (at least one PrEP dose in the past 3-day) was the most common report (84 % of participants), and among these 83 % did have quantifiable levels of drug. The vast majority of those reporting no doses in the past 3-day (16 % of the sample) did not have quantifiable levels of drug (82 %). Predictors of over-report of dosing included younger age and lower educational attainment. Monitoring recent PrEP use through neutral interviewing may be a productive approach for clinicians to consider in implementation of real-world PrEP. Strategies to capture longer term or prevention-effective PrEP use, particularly for younger cohorts, are needed.
authors.affiliation: Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA. ramico@umich.edu.
authors.forename: K Rivet
authors.initials: KR
authors.lastname: Amico
authors.affiliation: Gladstone Institute of Virology and Immunology, University of California, San Francisco, CA, USA.
authors.forename: Megha
authors.initials: M
authors.lastname: Mehrotra
authors.affiliation: University of Sao Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Vivian I
authors.initials: VI
authors.lastname: Avelino-Silva
authors.affiliation: Gladstone Institute of Virology and Immunology, University of California, San Francisco, CA, USA.
authors.forename: Vanessa
authors.initials: V
authors.lastname: McMahan
authors.affiliation: Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.
authors.forename: Valdilea G
authors.initials: VG
authors.lastname: Veloso
authors.affiliation: Department of Pharmaceutical Sciences, University of Colorado, Aurora, CO, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Anderson
authors.affiliation: Investigaciones Medicas en Salud, Lima, Peru.
authors.forename: Juan
authors.initials: J
authors.lastname: Guanira
authors.affiliation: Gladstone Institute of Virology and Immunology, University of California, San Francisco, CA, USA.|University of California, San Francisco, CA, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Grant
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000097:blood; D002853:Chromatography, Liquid; D017280:Condoms / Q000706:statistics & numerical data*; D059788:Dried Blood Spot Testing; D000068679:Emtricitabine; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D008297:Male; D055118:Medication Adherence; D065129:Pre-Exposure Prophylaxis; D057566:Self Report; D053719:Tandem Mass Spectrometry; D000068698:Tenofovir
chemical_list: D019380:Anti-HIV Agents; D000068698:Tenofovir; D000068679:Emtricitabine
keywords: Demonstration project; Drug levels; FTC/TDF; Open-label; PrEP adherence; Self-report; iPrEx