Self-reported Recent PrEP Dosing and Drug Detection in an Open Label PrEP Study.
Self-reported Recent PrEP Dosing and Drug Detection in an Open Label PrEP Study.
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DOI：
10.1007/s10461-016-1360-7
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发表时间：
2016-07
影响因子：
4.4
通讯作者：
iPrEx Study Team
中科院分区：
文献类型：
--
作者：
Amico KR;Mehrotra M;Avelino-Silva VI;McMahan V;Veloso VG;Anderson P;Guanira J;Grant R;iPrEx Study Team
监测暴露前预防(PrEP)的依从性是PrEP处方推荐方案的一部分，但临床试验中报告和实际使用的严重差异加剧了人们对如何自信地做到这一点的持续担忧。我们评估了通过中性访谈收集的最近PrEP剂量报告与Iprex开放标签扩展中的药物定量之间的一致性，其中参与者(n=11172)可以选择接受或不接受PrEP。最近剂量的自我报告(在过去3天内至少有一次PrEP剂量)是最常见的报告(84%的参与者)，其中83%的人确实有可量化的药物水平。绝大多数报告在过去3天内没有剂量的人(占样本的16%)没有可量化的药物水平(82%)。过量报告服药的预测因素包括年龄较小和教育程度较低。通过中性访谈监测最近PrEP的使用可能是临床医生在实施现实世界PrEP时考虑的一种有效方法。需要制定战略，以获取长期或预防有效的PrEP使用，特别是对年轻人群。
Monitoring adherence to pre-exposure prophylaxis (PrEP) is part of the recommended package for PrEP prescribing, yet ongoing concerns about how to do so confidently are exacerbated by gross discrepancies in reported and actual use in clinical trials. We evaluated concordance between reports of recent PrEP dosing collected via neutral interviewing and drug quantitation in the iPrEx open-label extension, where participants (n = 1172) had the choice to receive or not receive PrEP. Self-report of recent dosing (at least one PrEP dose in the past 3-day) was the most common report (84 % of participants), and among these 83 % did have quantifiable levels of drug. The vast majority of those reporting no doses in the past 3-day (16 % of the sample) did not have quantifiable levels of drug (82 %). Predictors of over-report of dosing included younger age and lower educational attainment. Monitoring recent PrEP use through neutral interviewing may be a productive approach for clinicians to consider in implementation of real-world PrEP. Strategies to capture longer term or prevention-effective PrEP use, particularly for younger cohorts, are needed.