Additional Support Needed to Maintain PrEP Adherence in Adolescents
HealthDay News — For adolescent men who have sex with men (MSM) participating in a 48-week HIV pre-exposure prophylaxis (PrEP) intervention, adherence decreases with quarterly visits, according to a study published online September 5 in JAMA Pediatrics.
Sybil G. Hosek, PhD, from Stronger Hospital of Cook County in Chicago, and colleagues examined the safety of and adherence to PrEP and changes in sexual risk behavior among adolescent MSM. Participants were recruited from adolescent medicine clinics and their community partners; they completed an individualized evidence-based behavioral intervention and were provided with daily tenofovir disoproxil fumarate/emtricitabine for 48 weeks. Seventy-eight adolescents (mean age, 16.5 years) were enrolled (two Asian/Pacific Islanders, 23 blacks/African-Americans, 11 whites, 16 white Hispanics, and 26 participants of other/mixed race/ethnicity).
The researchers diagnosed 23 sexually transmitted infections in 12 participants over 48 weeks of PrEP use. Per 100 person-years, the HIV seroconversion rate was 6.4. At weeks 4, 8, 12, 24, 36, and 48, tenofovir diphosphate levels consistent with a high degree of anti-HIV protection were found in 54, 47, 49, 28, 17, and 22% of participants, respectively.
"Approximately half achieved protective drug levels during the monthly visits, but adherence decreased with quarterly visits," the authors write. "Youth may need additional contact with clinical staff members to maintain high adherence."
Two authors disclosed ties to pharmaceutical companies, including Gilead Sciences, which provided funding and drugs for the study.