Monitoring Ups Adherence to Antiretroviral Prophylaxis
(HealthDay News) – High adherence to oral antiretroviral pre-exposure prophylaxis is achieved when HIV serodiscordant couples receive active monitoring and counseling, according to research published online Sept. 10 in PLOS Medicine.
Jessica E. Haberer, MD, of Harvard Medical School in Boston, and colleagues collected data from a sample of 1,147 uninfected partners, from serodiscordant heterosexual couples in East Africa, who were randomized to oral antiretroviral prophylaxis (tenofovir or emtricitabine/tenofovir) or placebo. Adherence to antiretroviral prophylaxis by the uninfected partners was measured with unannounced pill counts at the home and electronic pill bottle monitoring, and participants received individual and couples-based counseling.
The researchers found 14 HIV infections among participants in the adherence study, all of which occurred in those assigned to placebo. Almost complete adherence to antiretroviral prophylaxis was recorded by unannounced pill counts and electronic pill bottle monitoring. Factors associated with <80% adherence were no sex or sex with a person other than the study partner, younger age, and heavy alcohol use. Factors associated with >80% adherence were the first six months of pre-exposure prophylaxis and polygamous marriage.
"The high pre-exposure prophylaxis adherence achieved in the setting of active adherence monitoring and counseling support was associated with a high degree of protection from HIV acquisition by the HIV-uninfected partner in heterosexual serodiscordant couples," the authors write.