Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
The Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa.
AIDS. 2022 Jul 1;36(8):1151-1159. doi: 10.1097/QAD.0000000000003216. Epub 2022 May 16.
To estimate the effect of intimate partner violence (IPV) on oral pre-exposure prophylaxis (PrEP) adherence among adolescent girls and young women (AGYW).
We conducted a secondary analysis of data from HIV Prevention Trials Network 082 (HPTN 082), a multisite prospective study designed to assess oral PrEP adherence among AGYW in southern Africa.
We estimated the relative prevalence of high PrEP adherence 3 and 6 months after initiation among AGYW 16-25 years who reported a history of any IPV in the past year at enrollment versus AGYW who did not, both overall and by age. High adherence was defined as an intracellular tenofovir-diphosphate concentration at least 700 fmol/punch or more dried blood spots.
Among 409 PrEP-initiating AGYW, half (49%) reported experiencing any IPV by a current/recent partner in the year prior to enrollment. Overall, a similar proportion of AGYW who reported IPV had high PrEP adherence at months 3 and 6 as AGYW who did not report IPV. There was, however, evidence of effect modification by age at month 3: among AGYW less than 21 years old, those who reported IPV were less than half as likely to have high adherence [adjusted PR (aPR) = 0.43, 95% confidence interval (CI) 0.22-0.86]; among AGYW aged 21 years or older, those who reported IPV were more than twice as likely to have high adherence (aPR = 2.21, 95% CI 1.34-3.66). At month 6, effect estimates within each age stratum were consistent in direction to those at month 3.
IPV events may either impede or motivate PrEP adherence among African AGYW, with age appearing to be an important consideration for IPV-related adherence interventions.
评估亲密伴侣暴力（IPV）对青少年女孩和年轻女性（AGYW）接受口腔暴露前预防（PrEP）的影响。
我们对南部非洲 HIV 预防试验网络 082 （HPTN 082）的数据进行了二次分析，该研究是一项多地点前瞻性研究，旨在评估南部非洲 AGYW 口服 PrEP 的依从性。
我们估计了在开始使用 PrEP 后 3 个月和 6 个月时，在过去 1 年内报告有任何 IPV 史的 16-25 岁 AGYW 与没有报告有任何 IPV 史的 AGYW 之间的高 PrEP 依从性相对流行率，两者均为总体和按年龄分层。高依从性定义为至少有 700 fmol/打孔或更多干血斑的细胞内替诺福韦二磷酸浓度。
在 409 名开始使用 PrEP 的 AGYW 中，有一半（49%）报告在入组前 1 年内与当前/最近的伴侣发生过任何 IPV。总体而言，报告有 IPV 的 AGYW 在 3 个月和 6 个月时具有高 PrEP 依从性的比例与未报告 IPV 的 AGYW相似。然而，在 3 个月时存在年龄的交互作用：在年龄小于 21 岁的 AGYW 中，报告有 IPV 的人不太可能有高依从性（调整后的 PR[aPR]＝0.43，95%置信区间[CI]0.22-0.86）；在年龄为 21 岁或以上的 AGYW 中，报告有 IPV 的人有高依从性的可能性是未报告有 IPV 的人的两倍多（aPR＝2.21，95% CI 1.34-3.66）。在 6 个月时，每个年龄组内的效应估计与 3 个月时的一致。
在非洲 AGYW 中，IPV 事件可能会阻碍或促进 PrEP 的依从性，年龄似乎是与 IPV 相关的依从性干预措施的一个重要考虑因素。
