Pre-exposure Prophylaxis Recent Adherence With Real-Time Adherence Feedback and Partner Human Immunodeficiency Virus Self-Testing: A Pilot Trial Among Postpartum Women.
Open Forum Infect Dis
; 9(2): ofab609, 2022 Feb.
Article
in En
| MEDLINE
| ID: mdl-35097151
ABSTRACT
BACKGROUND:
Pre-exposure prophylaxis (PrEP) is safe and effective in postpartum women. Human immunodeficiency virus self-testing (HIVST) for male partners combined with biofeedback counseling through real-time adherence measures may improve PrEP use among postpartum women.METHODS:
Between August 2020 and April 2021, we randomized postpartum women who initiated PrEP in pregnancy 11 to the intervention group (HIVSTâ +â biofeedback counseling after urine tenofovir test) or to standard of care ([SOC] facility-based human immunodeficiency virus [HIV] tests and routine counseling without biofeedback). The outcomes of interest were PrEP adherence in the past 48-72 hours via urine tenofovir tests and partner HIV testing, measured 1-month after randomization. Secondary outcomes included the proportion of partners who tested for HIV and the discrepancy between self-reported PrEP adherence and urine tenofovir result.RESULTS:
We enrolled 106 women (median ageâ =â 26 years). At enrollment, 72% of women reported missingâ <2 doses in the past 7 days; 36% of women had tenofovir present in her urine. One month after enrollment, 62% (nâ =â 33) of women in the intervention arm had tenofovir present in their urine compared to 34% (nâ =â 18) in SOC (risk ratio [RR]â =â 1.83; 95% confidence interval [CI]â =â 1.19-2.82; Pâ =â .001). Two thirds of women in the intervention arm reported that her partner tested for HIV (66%; nâ =â 35), compared to 17% (nâ =â 9) in SOC (RRâ =â 3.89; 95% CIâ =â 2.08-7.27; Pâ <â .001). Self-reported PrEP adherence (took PrEPâ >5 of last week) with no tenofovir in urine test was lower in the intervention group (17% vs 46%; RRâ =â 0.33; 95% CIâ =â 0.17-0.67; Pâ =â .03). No social or clinical adverse events were reported in the intervention arm.CONCLUSIONS:
The HIVST for partners and biofeedback counseling increased levels of recent PrEP adherence, pointing to the importance of these interventions to support PrEP use in this population.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Type of study:
Clinical_trials
Language:
En
Journal:
Open Forum Infect Dis
Year:
2022
Document type:
Article
Affiliation country:
United States