Programme Santé de Lutte contre le Sida (PSLS), Cotonou, Bénin.
Johns Hopkins University School of Medicine, Baltimore, MD.
Sex Transm Dis. 2021 Aug 1;48(8):565-571. doi: 10.1097/OLQ.0000000000001373.
HIV preexposure prophylaxis (PrEP) efficacy is closely linked to adherence, and factors associated with PrEP adherence are not well understood and may differ across populations. As PrEP demonstration projects and implementation are ongoing, it is essential to understand factors associated with adherence to oral PrEP to design effective adherence interventions and maximize the public health impact of PrEP. We thus aimed to assess demographic and behavioral factors associated with optimal PrEP adherence (100%) among female sex workers (FSWs) participating in a demonstration project in Cotonou, Benin.
Female sex workers were provided with daily Truvada and followed quarterly for 1 to 2 years. Sociodemographics, partners, and behaviors were collected through face-to-face questionnaires. Another questionnaire based on sexual the theory of planned behavior and the theory of interpersonal behavior was also administered. Generalized estimating equations were used to identify factors associated with optimal daily adherence.
At baseline, 255 FSWs were followed up. One-year increase in age of FSWs was associated with a 3% increase in optimal adherence (prevalence ratio, 1.03; 95% confidence interval, 1.01-1.05; P for trend = 0.0003), and optimal adherence decreased by 31% for every 6 months of follow-up (prevalence ratio, 0.69; 95% confidence interval, 0.59-0.79; P for trend < 0.0001). For the participants who have completed the behavioral questionnaires, high intention to adhere to the treatment was also a predictor of optimal adherence.
Efforts should be geared toward FSWs intending to use PrEP to help them reach adequate adherence levels for effective HIV protection.
HIV 暴露前预防（PrEP）的效果与依从性密切相关，而与 PrEP 依从性相关的因素尚不清楚，且可能因人群而异。随着 PrEP 示范项目和实施的进行，了解与口服 PrEP 依从性相关的因素对于设计有效的依从性干预措施以及最大限度地发挥 PrEP 的公共卫生影响至关重要。因此，我们旨在评估参与贝宁科托努示范项目的女性性工作者（FSW）中与最佳 PrEP 依从性（100%）相关的人口统计学和行为因素。
为女性性工作者提供每日特鲁瓦达，并在 1 至 2 年内每季度进行随访。通过面对面问卷收集社会人口统计学、伴侣和行为信息。还进行了另一个基于性计划行为理论和人际行为理论的问卷。使用广义估计方程来确定与最佳每日依从性相关的因素。
在基线时，有 255 名 FSW 接受了随访。FSW 年龄每增加 1 岁，最佳依从性增加 3%（优势比，1.03；95%置信区间，1.01-1.05；趋势 P 值=0.0003），每随访 6 个月，最佳依从性降低 31%（优势比，0.69；95%置信区间，0.59-0.79；趋势 P 值<0.0001）。对于完成行为问卷的参与者，坚持治疗的强烈意愿也是最佳依从性的预测因素。
应针对打算使用 PrEP 的 FSW 做出努力，以帮助他们达到有效 HIV 保护所需的足够依从水平。
