Understanding Adherence to Daily and Intermittent Regimens of Oral HIV Pre-exposure Prophylaxis Among Men Who Have Sex with Men in Kenya

Authors

Peter Mwangi Mugo, Kenya Medical Research Institute
Eduard J. Sanders, University of Oxford
Gaudensia Mutua, University of Nairobi
Elisabeth van der Elst, Kenya Medical Research Institute
Omu Anzala, University of Nairobi
Burc Barin, EMMES Corporation
David Bangsberg, Portland State UniversityFollow
Frances H. Priddy, International AIDS Vaccine Initiative
Jessica E. Haberer, Massachusetts General HospitalFollow

Published In

AIDS and Behavior

Document Type

Article

Publication Date

11-2014

Subjects

HIV infections -- Kenya -- Treatment, AIDS (Disease) -- Kenya -- Treatment, HIV-positive gay men -- Kenya -- Behavior -- Qualitative studies

Physical Description

8 pages

Abstract

A qualitative assessment of Kenyan men who have sex with men taking daily and intermittent oral HIV preexposure prophylaxis (PrEP) found stigma, sex work, mobility, and alcohol impacted adherence. We analyzed quantitative data from the same cohort to explore different definitions of intermittent adherence. Volunteers were randomized to daily emtricitabine/tenofovir or placebo, or intermittent (prescription: Mondays/Fridays/after sex, maximum1 dose/day)emtricitabine/tenofovir or placebo (2:1:2:1), and followed for 4 months. By electronic monitoring, median adherence for daily dosing was 80 %. Median adherence for intermittent dosing was 71 % per a ‘‘relaxed’’ definition (accounting for off-prescription dosing) and 40 % per a ‘‘strict’’ definition (limited to the prescription). Factors associated with lower adherence included travel, transactional sex, and longer follow-up; higher adherence was associated with daily dosing and an income. The definition of intermittent dosing strongly affects interpretation of adherence. These findings suggest interventions should address challenges of mobility, sex work, and long-term PrEP.

Description

At the time of writing, David Bangsberg was affiliated with Massachusetts General Hospital.

Origianlly appeared in Aids and Behavior, vol. 19, no. 5, 2015, published by Springer. May be found at http://dx.doi.org/10.1007/s10461-014-0958-x.

©The Author(s) 2014. This article is published with open access at Springerlink.com

DOI

10.1007/s10461-014-0958-x

Persistent Identifier

http://archives.pdx.edu/ds/psu/18536

Publisher

Springer

Citation Details

Mugo, Peter Mwangi, Eduard J. Sanders, Gaudensia Mutua, Elisabeth van der Elst, Omu Anzala, Burc Barin, David R. Bangsberg, Frances H. Priddy, and Jessica E. Haberer. "Understanding adherence to daily and intermittent regimens of oral HIV pre-exposure prophylaxis among men who have sex with men in Kenya." AIDS and Behavior 19, no. 5 (2015): 794-801.