Musinguzi Nicholas, Pyra Maria, Bukusi Elizabeth A, Mugo Nelly R, Baeten Jared M, Haberer Jessica E
Global Health Collaborative, Mbarara University of Science and Technology, Plot 10/24, Lower Circular Road, Mbarara, Uganda.
Department of Medicine, University of Chicago, Chicago, USA.
AIDS Behav. 2023 Jan;27(1):171-181. doi: 10.1007/s10461-022-03753-y. Epub 2022 Jul 16.
Using data from a 2-year study of young women at high HIV risk in Thika and Kisumu, Kenya, we identified group-based trajectories of PrEP adherence based on electronic pillcap-monitoring and assessed potentially associated demographic and socio-behavioral factors. Among 348 women, we selected a three-trajectory adherence model: low and declining (N = 211, 61%), moderate but declining (N = 119, 34%) and steady high adherers (N = 18, 5%). We also identified a two-trajectory HIV risk model based on self-perceived risk in the past week: high and increasing (N = 28, 8%) and steady low (N = 320, 92%) risk. The Kisumu site was associated with the moderate but declining and steady high adherence trajectories, while increasing VOICE risk score was associated with the low and declining adherence trajectory. We found no association between the adherence and risk trajectories. Our findings suggest adherence support may need tailoring by setting. Early, sustained support may also help those at highest risk of non-adherence.
利用肯尼亚锡卡和基苏木对高HIV感染风险年轻女性进行的一项为期两年研究的数据，我们基于电子药瓶盖监测确定了基于群组的暴露前预防（PrEP）依从性轨迹，并评估了潜在相关的人口统计学和社会行为因素。在348名女性中，我们选择了一个三轨迹依从性模型：低且下降型（N = 211，61%）、中等但下降型（N = 119，34%）和持续高依从型（N = 18，5%）。我们还根据过去一周的自我感知风险确定了一个双轨迹HIV风险模型：高且上升型（N = 28，8%）和持续低风险型（N = 320，92%）。基苏木研究点与中等但下降型和持续高依从性轨迹相关，而VOICE风险评分增加与低且下降型依从轨迹相关。我们发现依从性轨迹和风险轨迹之间没有关联。我们的研究结果表明，依从性支持可能需要根据研究点进行调整。早期、持续的支持也可能有助于那些不依从风险最高的人群。
