Stirratt Michael J, Gordon Christopher M
Center for Mental Health Research on AIDS, National Institute of Mental Health, 6001 Executive Boulevard, Room 6199, Bethesda, MD 20892, USA.
Curr HIV/AIDS Rep. 2008 Nov;5(4):186-92. doi: 10.1007/s11904-008-0027-z.
Biomedical approaches to HIV prevention (eg, microbicides, antiretroviral preexposure prophylaxis) are undergoing clinical trials to test their efficacy. One key consideration emerging from completed trials is the critical role of adherence to the investigational product. Suboptimal product adherence may compromise clinical trial results and ultimately undermine the effectiveness of biomedical prevention methods in any future real-world use. Efforts to strengthen biomedical HIV prevention product adherence can benefit from existing research methodologies, findings, and interventions developed for adherence to HIV treatment. Research on treatment adherence is most relevant to medication-based biomedical prevention strategies, such as antiretroviral preexposure prophylaxis and acyclovir for herpes simplex virus-2. Three areas where HIV treatment adherence literature can inform research on such biomedical prevention strategies are 1) specialized methods for assessing medication adherence, 2) research findings emphasizing social context as an adherence determinant, and 3) promising behavioral interventions to improve adherence.
预防艾滋病病毒的生物医学方法（如杀菌剂、抗逆转录病毒药物暴露前预防）正在进行临床试验以测试其疗效。已完成的试验中出现的一个关键考虑因素是坚持使用研究产品的关键作用。对产品的依从性欠佳可能会影响临床试验结果，并最终损害生物医学预防方法在未来任何实际应用中的有效性。加强艾滋病病毒生物医学预防产品依从性的努力可受益于现有的研究方法、研究结果以及为坚持艾滋病病毒治疗而开发的干预措施。关于治疗依从性的研究与基于药物的生物医学预防策略最为相关，如抗逆转录病毒药物暴露前预防以及用于单纯疱疹病毒2型的阿昔洛韦。艾滋病病毒治疗依从性文献可为这类生物医学预防策略的研究提供信息的三个领域是：1）评估药物依从性的专门方法，2）强调社会环境作为依从性决定因素的研究结果，3）有望改善依从性的行为干预措施。
