| Title |
Adherence to Pre-Exposure Prophylaxis for HIV Prevention in a Clinical Setting
|
|---|---|
| Published in |
PLOS ONE, June 2016
|
| DOI | 10.1371/journal.pone.0157742 |
| Pubmed ID | |
| Authors |
Madeline C. Montgomery, Catherine E. Oldenburg, Amy S. Nunn, Leandro Mena, Peter Anderson, Teri Liegler, Kenneth H. Mayer, Rupa Patel, Alexi Almonte, Philip A. Chan |
| Abstract |
The HIV epidemic in the United States (US) disproportionately affects gay, bisexual, and other men who have sex with men (MSM). Pre-exposure prophylaxis (PrEP) using co-formulated tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC) has demonstrated high efficacy in reducing HIV incidence among MSM. However, low adherence was reported in major efficacy trials and may present a substantial barrier to successful PrEP implementation. Rates of adherence to PrEP in "real-world" clinical settings in the US remain largely unknown. We reviewed demographic and clinical data for the first 50 patients to enroll in a clinical PrEP program in Providence, Rhode Island. We analyzed self-reported drug adherence as well as drug concentrations in dried blood spots (DBS) from patients who attended either a three- or six-month follow-up appointment. We further assessed drug concentrations and the resistance profile of a single patient who seroconverted while taking PrEP. Of the first 50 patients to be prescribed PrEP, 62% attended a follow-up appointment at three months and 38% at six months. Of those who attended an appointment at either time point (70%, n = 35), 92% and 95% reported taking ±4 doses/week at three and six months, respectively. Drug concentrations were performed on a random sample of 20 of the 35 patients who attended a follow-up appointment. TDF levels consistent with ±4 doses/week were found in 90% of these patients. There was a significant correlation between self-reported adherence and drug concentrations (r = 0.49, p = 0.02). One patient who had been prescribed PrEP seroconverted at his three-month follow-up visit. The patient's drug concentrations were consistent with daily dosing. Population sequencing and ultrasensitive allele-specific PCR detected the M184V mutation, but no other TDF- or FTC-associated mutations, including those present as minor variants. In this clinical PrEP program, adherence was high, and self-reported drug adherence accurately reflected drug concentrations as measured by DBS. |
X Demographics
The data shown below were collected from the profiles of 9 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 3 | 33% |
| Australia | 1 | 11% |
| United Kingdom | 1 | 11% |
| Unknown | 4 | 44% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 9 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 154 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | <1% |
| Brazil | 1 | <1% |
| Unknown | 152 | 99% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 31 | 20% |
| Researcher | 22 | 14% |
| Student > Ph. D. Student | 13 | 8% |
| Student > Postgraduate | 12 | 8% |
| Student > Bachelor | 11 | 7% |
| Other | 37 | 24% |
| Unknown | 28 | 18% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 44 | 29% |
| Social Sciences | 23 | 15% |
| Nursing and Health Professions | 21 | 14% |
| Psychology | 8 | 5% |
| Biochemistry, Genetics and Molecular Biology | 6 | 4% |
| Other | 17 | 11% |
| Unknown | 35 | 23% |
Attention Score in Context
This research output has an Altmetric Attention Score of 8. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 June 2019.
All research outputs
#4,693,974
of 25,795,662 outputs
Outputs from PLOS ONE
#83,357
of 224,881 outputs
Outputs of similar age
#76,149
of 369,982 outputs
Outputs of similar age from PLOS ONE
#1,120
of 4,595 outputs
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