Minnis Alexandra M, van der Straten Ariane, Salee Parichat, Hendrix Craig W
Women's Global Health Imperative, RTI International, 351 California Street, Suite 500, San Francisco, CA, 94104, USA.
School of Public Health, University of California, Berkeley, USA.
AIDS Behav. 2016 Jul;20(7):1541-8. doi: 10.1007/s10461-015-1081-3.
Despite strong evidence that daily oral pre-exposure prophylaxis (PrEP) reduces HIV risk, effectiveness across studies has varied. Inconsistent adherence constitutes one explanation. Efforts to examine adherence are limited when they rely on self-reported measures. We examined recent adherence as measured by plasma tenofovir (TFV) concentration in participants of MTN-001, a phase 2 cross-over trial comparing oral tablet and vaginal gel formulations of TFV among 144 HIV-uninfected women at sites in the United States (U.S.) and sub-Saharan Africa (SSA). Adherence to daily product use was higher in the U.S. than in the SSA sites. Within region, however, adherence was similar between products. In the U.S., gel adherence was higher among married women, and lower among women using male condoms and injectable contraceptives. At the SSA sites, gel adherence was lower for younger women. Inconsistent adherence points to challenges in use of daily PrEP, even during a trial of short duration.
尽管有强有力的证据表明每日口服暴露前预防（PrEP）可降低感染艾滋病毒的风险，但不同研究的效果存在差异。依从性不一致是一种解释。当依赖自我报告的测量方法时，检查依从性的努力是有限的。我们通过血浆替诺福韦（TFV）浓度来检测MTN - 001参与者最近的依从性，MTN - 001是一项2期交叉试验，在美国（U.S.）和撒哈拉以南非洲（SSA）的多个地点，对144名未感染艾滋病毒的女性比较TFV的口服片剂和阴道凝胶制剂。美国每日产品使用的依从性高于撒哈拉以南非洲地区的地点。然而，在各地区内，不同产品之间的依从性相似。在美国，已婚女性使用凝胶的依从性较高，而使用男用避孕套和注射用避孕药的女性依从性较低。在撒哈拉以南非洲地区的地点，年轻女性使用凝胶的依从性较低。即使在短期试验期间，依从性不一致也表明每日使用PrEP存在挑战。
