Haberer Jessica E, Ngure Kenneth, Muwonge Timothy, Mugo Nelly, Katabira Elly, Heffron Renee, Musinguzi Nicholas, Bangsberg David R, Celum Connie, Baeten Jared M
*MGH Global Health, Boston, MA; †Kenya Medical Research Institute, Thika, Kenya; ‡Infectious Disease Institute, Kampala, Uganda; §Department of Global Health, University of Washington, Seattle, WA; ‖Mbarara University of Science and Technology, Mbarara, Uganda; and ¶Oregon Health and Sciences University-Portland State University School of Public Health, Portland, OR.
J Acquir Immune Defic Syndr. 2017 Dec 15;76(5):488-492. doi: 10.1097/QAI.0000000000001548.
Short message service (SMS) surveys are a promising tool for understanding whether preexposure prophylaxis (PrEP) adherence aligns with risk for HIV acquisition-a concept known as prevention-effective adherence.
The Partners Demonstration Project was an open-label study of integrated PrEP and antiretroviral therapy (ART) delivery among high-risk HIV serodiscordant couples in East Africa. HIV-uninfected partners were offered PrEP until their HIV-infected partner had taken ART for ≥6 months. At 2 study sites, HIV-uninfected partners were offered enrollment into the Partners Mobile Adherence to PrEP (PMAP) substudy based on ongoing PrEP use, personal cell phone ownership, and ability to use SMS. SMS surveys asked about PrEP adherence and sexual activity in the previous 24 hours; these surveys were sent daily for the 7 days before and 7 days after routine study visits in the Partners Demonstration Project.
The PMAP substudy enrolled 373 HIV-uninfected partners; 69% were men and mean age was 31 years. Participants completed 17,030 of 23,056 SMS surveys sent (74%) with a mean of 47 surveys per participant over 9.8 months of follow-up. While HIV-infected partner use of ART was <6 months, mean reported PrEP adherence was 92% on surveys concurrently reporting sex within the serodiscordant partnership, and 84% on surveys reporting no sex (P < 0.001).
SMS surveys provided daily assessment of concurrent PrEP adherence and sexual behavior. Higher PrEP adherence was temporally associated with increased risk for HIV acquisition.
短信服务（SMS）调查是一种很有前景的工具，可用于了解暴露前预防（PrEP）的依从性是否与获得艾滋病毒的风险相符——这一概念被称为预防有效依从性。
伙伴示范项目是一项在东非高危艾滋病毒血清学不一致的夫妇中开展的关于综合PrEP和抗逆转录病毒疗法（ART）给药的开放标签研究。未感染艾滋病毒的伴侣可获得PrEP，直至其感染艾滋病毒的伴侣接受ART治疗≥6个月。在2个研究地点，根据持续使用PrEP、拥有个人手机以及使用短信的能力，邀请未感染艾滋病毒的伴侣参加伙伴PrEP移动依从性（PMAP）子研究。短信调查询问了前24小时内的PrEP依从性和性行为；在伙伴示范项目的常规研究访视前7天和访视后7天每天发送这些调查。
PMAP子研究招募了373名未感染艾滋病毒的伴侣；69%为男性，平均年龄为31岁。在发送的23,056份短信调查中，参与者完成了17,030份（74%），在9.8个月的随访中，每位参与者平均完成47份调查。在艾滋病毒感染伴侣接受ART治疗<6个月时，在同时报告血清学不一致伴侣关系内有性行为的调查中，报告的PrEP平均依从率为92%，在报告无性行为的调查中为84%（P<0.001）。
短信调查提供了对PrEP依从性和性行为的每日评估。较高的PrEP依从性在时间上与获得艾滋病毒的风险增加相关。
