The impact of adherence to preexposure prophylaxis on the risk of HIV infection among people who inject drugs.
AIDS
; 29(7): 819-24, 2015 Apr 24.
Article
en En
| MEDLINE
| ID: mdl-25985403
ABSTRACT
OBJECTIVE:
To describe participant adherence to daily oral tenofovir in an HIV preexposure prophylaxis (PrEP) trial, examine factors associated with adherence, and assess the impact of adherence on the risk of HIV infection.DESIGN:
The Bangkok Tenofovir Study was a randomized, double-blind, placebo-controlled trial conducted among people who inject drugs, 2005-2012.METHODS:
Participants chose daily visits or monthly visits. Study nurses observed participants swallow study drug and both initialed a diary. We assessed adherence using the diary. We examined adherence by age group and sex and used logistic regression to evaluate demographics and risk behaviors as predictors of adherence and Cox regression to assess the impact of adherence on the risk of HIV infection.RESULTS:
A total of 2413 people enrolled and contributed 9665 person-years of follow-up (mean 4.0 years, maximum 6.9 years). The risk of HIV infection decreased as adherence improved, from 48.9% overall to 83.5% for those with at least 97.5% adherence. In multivariable analysis, men were less adherent than women (Pâ=â0.006) and participants 20-29 years old (Pâ<â0.001) and 30-39 years old (Pâ=â0.01) were less adherent than older participants. Other factors associated with poor adherence included incarceration (Pâ=â0.02) and injecting methamphetamine (Pâ=â0.04).CONCLUSION:
In this HIV PrEP trial among people who inject drugs, improved adherence to daily tenofovir was associated with a lower risk of HIV infection. This is consistent with trials among MSM and HIV-discordant heterosexual couples and suggests that HIV PrEP can provide a high level of protection from HIV infection.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Infecciones por VIH
/
Abuso de Sustancias por Vía Intravenosa
/
Cumplimiento de la Medicación
/
Profilaxis Pre-Exposición
Tipo de estudio:
Clinical_trials
/
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
AIDS
Asunto de la revista:
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Año:
2015
Tipo del documento:
Article
País de afiliación:
Tailandia