@article{e51275d00bdb48e193f094bd4a779b59,
title = "Utility of Different Adherence Measures for PrEP: Patterns and Incremental Value",
abstract = "Measuring PrEP adherence remains challenging. In 2009–2010, the International AIDS Vaccine Initiative randomized phase II trial participants to daily tenofovir disoproxil fumarate/emtricitabine or placebo in Uganda and Kenya. Adherence was measured by electronic monitoring (EM), self-report (SR), and drug concentrations in plasma and hair. Each adherence measure was categorised as low, moderate, or high and also considered continuously; the incremental value of combining measures was determined. Forty-five participants were followed over 4 months. Discrimination for EM adherence by area under receiver operating curves (AROC) was poor for SR (0.53) and best for hair (AROC 0.85). When combining hair with plasma or hair with self-report, discrimination was improved (AROC > 0.9). Self-reported adherence was of low utility by itself. Hair level was the single best PK measure to predict EM-assessed adherence; the other measurements had lower discrimination values. Combining short-term (plasma) and long-term (hair) metrics could be useful to assess patterns of drug-taking in the context of PrEP.",
keywords = "Hair, Plasma, PrEP drug-taking patterns of adherence electronic monitoring",
author = "Andrew Abaasa and Craig Hendrix and Monica Gandhi and Peter Anderson and Anatoli Kamali and Freddie Kibengo and Sanders, {Eduard J.} and Gaudensia Mutua and Bumpus, {Namandj{\'e} N.} and Frances Priddy and Haberer, {Jessica E.}",
note = "Funding Information: Acknowledgements IAVI{\textquoteright}s work is made possible by generous support from many donors including: The Bill & Melinda Gates Foundation; the Ministry of Foreign Affairs of Denmark; Irish Aid; the Ministry of Finance of Japan in partnership with The World Bank; the Ministry of Foreign Affairs of the Netherlands; the Norwegian Agency for Development Cooperation (NORAD); the United Kingdom Department for International Development (DFID), and the United States Agency for International Development (USAID). The full list of IAVI donors is available at www.iavi.org. The contents are the responsibility of the International AIDS Vaccine Initiative and do not necessarily reflect the views of USAID or the United States Government. The authors would like to thank members of the Hair Analytical Laboratory Funding Information: Funding The trials were funded and sponsored by the International AIDS Vaccine Initiative (www.iavi.org). Funding for the hair assays was provided by the National Institute of Allergy and Infectious Diseases (NIAID)/National Institutes of Health (NIH) (2R01 AI098472 to P.I. Monica Gandhi), K24MH114732E supported Jessica E. Haberer and Gilead Sciences provided trial medication (active drug and placebo). For this manuscript, the funder participated in study design and manuscript review, but had no role in data analysis. Publisher Copyright: {\textcopyright} 2017, The Author(s).",
year = "2018",
month = apr,
day = "1",
doi = "10.1007/s10461-017-1951-y",
language = "English (US)",
volume = "22",
pages = "1165--1173",
journal = "AIDS and behavior",
issn = "1090-7165",
publisher = "Springer New York",
number = "4",
}