Does Adherence Change When No One is Looking? Comparing Announced and Unannounced Tenofovir Levels in a PrEP Trial
Does Adherence Change When No One is Looking? Comparing Announced and Unannounced Tenofovir Levels in a PrEP Trial
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DOI：
10.1007/s10461-016-1292-2
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发表时间：
2016-11-01
影响因子：
4.4
通讯作者：
Haberer, Jessica E.
中科院分区：
文献类型：
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作者：
Musinguzi, Nicholas;Muwonge, Timothy;Haberer, Jessica E.
未公布的替诺福韦与公布的替诺福韦作为PrEP依从性指标之间的差异尚不清楚。在一项涉及partner PrEP研究的一个城市站点（坎帕拉）和两个农村站点（Kabwohe和Tororo）的辅助依从性研究中，按时间顺序对来自近端诊所和家访的268对标本进行了血浆替诺福韦水平检测。比较临床和家庭标本，89%和89%被分类为可检测的（> 0.31 ng/ml, p = 0.77）， 87%和86%被分类为最近给药（> 10 ng/ml, p = 0.80）， 82%和80%被分类为稳态（> 40 ng/ml, p = 0.44）。经标本采集时间调整后，公布与未公布药物水平的平均差异为：Kabwohe为3.2 ng/ml (p = 0.50)， Kampala为23.2 ng/ml (p = 0.003)， Tororo为-3.3 ng/ml （p = 0.69）。在高依从性的情况下，在诊所检测的血浆替诺福韦水平与在家检测的水平分类相似；然而，城市和农村环境之间存在差异。
Differences between unannounced and announced tenofovir levels as measures of PrEP adherence are not well understood. In an ancillary adherence study involving one urban site (Kampala) and two rural sites (Kabwohe and Tororo) from the Partners PrEP study, 268 specimen pairs from chronologically proximal clinic and home visits were tested for plasma tenofovir levels. Comparing clinic and home specimens, 89 versus 89 % were classified as detectable (> 0.31 ng/ml; p = 0.77), 87 versus 86 % as recent dosing (> 10 ng/ml; p = 0.80), and 82 versus 80 % as steady-state (> 40 ng/ml; p = 0.44). Mean difference between announced and unannounced drug levels, adjusted for specimen collection time was 3.2 ng/ml (p = 0.50) for Kabwohe, 23.2 ng/ml (p = 0.003) for Kampala and -3.3 ng/ml p = 0.69) for Tororo. In the setting of high adherence, plasma tenofovir levels tested at the clinic were categorically similar as levels tested at home; however, differences were seen between urban and rural settings.