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dc.contributor.authorMontgomery, Madeline C.en_US
dc.contributor.authorOldenburg, Catherine E.en_US
dc.contributor.authorNunn, Amy S.en_US
dc.contributor.authorMena, Leandroen_US
dc.contributor.authorAnderson, Peteren_US
dc.contributor.authorLiegler, Terien_US
dc.contributor.authorMayer, Kenneth H.en_US
dc.contributor.authorPatel, Rupaen_US
dc.contributor.authorAlmonte, Alexien_US
dc.contributor.authorChan, Philip A.en_US
dc.date.accessioned2016-08-09T14:54:58Z
dc.date.issued2016en_US
dc.identifier.citationMontgomery, Madeline C., Catherine E. Oldenburg, Amy S. Nunn, Leandro Mena, Peter Anderson, Teri Liegler, Kenneth H. Mayer, Rupa Patel, Alexi Almonte, and Philip A. Chan. 2016. “Adherence to Pre-Exposure Prophylaxis for HIV Prevention in a Clinical Setting.” PLoS ONE 11 (6): e0157742. doi:10.1371/journal.pone.0157742. http://dx.doi.org/10.1371/journal.pone.0157742.en
dc.identifier.issn1932-6203en
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:27822403
dc.description.abstractBackground: The HIV epidemic in the United States (US) disproportionately affects gay, bisexual, and other men who have sex with men (MSM). Pre-exposure prophylaxis (PrEP) using co-formulated tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC) has demonstrated high efficacy in reducing HIV incidence among MSM. However, low adherence was reported in major efficacy trials and may present a substantial barrier to successful PrEP implementation. Rates of adherence to PrEP in “real-world” clinical settings in the US remain largely unknown. Methods: We reviewed demographic and clinical data for the first 50 patients to enroll in a clinical PrEP program in Providence, Rhode Island. We analyzed self-reported drug adherence as well as drug concentrations in dried blood spots (DBS) from patients who attended either a three- or six-month follow-up appointment. We further assessed drug concentrations and the resistance profile of a single patient who seroconverted while taking PrEP. Results: Of the first 50 patients to be prescribed PrEP, 62% attended a follow-up appointment at three months and 38% at six months. Of those who attended an appointment at either time point (70%, n = 35), 92% and 95% reported taking ±4 doses/week at three and six months, respectively. Drug concentrations were performed on a random sample of 20 of the 35 patients who attended a follow-up appointment. TDF levels consistent with ±4 doses/week were found in 90% of these patients. There was a significant correlation between self-reported adherence and drug concentrations (r = 0.49, p = 0.02). One patient who had been prescribed PrEP seroconverted at his three-month follow-up visit. The patient’s drug concentrations were consistent with daily dosing. Population sequencing and ultrasensitive allele-specific PCR detected the M184V mutation, but no other TDF- or FTC-associated mutations, including those present as minor variants. Conclusion: In this clinical PrEP program, adherence was high, and self-reported drug adherence accurately reflected drug concentrations as measured by DBS.en
dc.language.isoen_USen
dc.publisherPublic Library of Scienceen
dc.relation.isversionofdoi:10.1371/journal.pone.0157742en
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC4917105/pdf/en
dash.licenseLAAen_US
dc.subjectBiology and Life Sciencesen
dc.subjectImmunologyen
dc.subjectVaccination and Immunizationen
dc.subjectProphylaxisen
dc.subjectPre-Exposure Prophylaxisen
dc.subjectMedicine and Health Sciencesen
dc.subjectPublic and Occupational Healthen
dc.subjectPreventive Medicineen
dc.subjectPharmacologyen
dc.subjectDrug Adherenceen
dc.subjectMicrobiologyen
dc.subjectMicrobial Controlen
dc.subjectAntimicrobial Resistanceen
dc.subjectMedicine and health sciencesen
dc.subjectPublic and occupational healthen
dc.subjectPreventive medicineen
dc.subjectHIV preventionen
dc.subjectHealth Careen
dc.subjectPatientsen
dc.subjectPeople and Placesen
dc.subjectPopulation Groupingsen
dc.subjectSexual Preferencesen
dc.subjectMen WHO Have Sex with Menen
dc.subjectMedical Microbiologyen
dc.subjectMicrobial Pathogensen
dc.subjectViral Pathogensen
dc.subjectImmunodeficiency Virusesen
dc.subjectHIVen
dc.subjectPathology and Laboratory Medicineen
dc.subjectPathogensen
dc.subjectOrganismsen
dc.subjectVirusesen
dc.subjectBiology and life sciencesen
dc.subjectRNA virusesen
dc.subjectRetrovirusesen
dc.subjectLentivirusen
dc.subjectInfectious diseasesen
dc.subjectViral diseasesen
dc.subjectHIV infectionsen
dc.titleAdherence to Pre-Exposure Prophylaxis for HIV Prevention in a Clinical Settingen
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden
dc.relation.journalPLoS ONEen
dash.depositing.authorMayer, Kenneth H.en_US
dc.date.available2016-08-09T14:54:58Z
dc.identifier.doi10.1371/journal.pone.0157742*
dash.contributor.affiliatedMayer, Kenneth
dc.identifier.orcid0000-0001-7460-733X


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