dc.contributor.author | Montgomery, Madeline C. | en_US |
dc.contributor.author | Oldenburg, Catherine E. | en_US |
dc.contributor.author | Nunn, Amy S. | en_US |
dc.contributor.author | Mena, Leandro | en_US |
dc.contributor.author | Anderson, Peter | en_US |
dc.contributor.author | Liegler, Teri | en_US |
dc.contributor.author | Mayer, Kenneth H. | en_US |
dc.contributor.author | Patel, Rupa | en_US |
dc.contributor.author | Almonte, Alexi | en_US |
dc.contributor.author | Chan, Philip A. | en_US |
dc.date.accessioned | 2016-08-09T14:54:58Z | |
dc.date.issued | 2016 | en_US |
dc.identifier.citation | Montgomery, 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.issn | 1932-6203 | en |
dc.identifier.uri | http://nrs.harvard.edu/urn-3:HUL.InstRepos:27822403 | |
dc.description.abstract | Background: 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.iso | en_US | en |
dc.publisher | Public Library of Science | en |
dc.relation.isversionof | doi:10.1371/journal.pone.0157742 | en |
dc.relation.hasversion | http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4917105/pdf/ | en |
dash.license | LAA | en_US |
dc.subject | Biology and Life Sciences | en |
dc.subject | Immunology | en |
dc.subject | Vaccination and Immunization | en |
dc.subject | Prophylaxis | en |
dc.subject | Pre-Exposure Prophylaxis | en |
dc.subject | Medicine and Health Sciences | en |
dc.subject | Public and Occupational Health | en |
dc.subject | Preventive Medicine | en |
dc.subject | Pharmacology | en |
dc.subject | Drug Adherence | en |
dc.subject | Microbiology | en |
dc.subject | Microbial Control | en |
dc.subject | Antimicrobial Resistance | en |
dc.subject | Medicine and health sciences | en |
dc.subject | Public and occupational health | en |
dc.subject | Preventive medicine | en |
dc.subject | HIV prevention | en |
dc.subject | Health Care | en |
dc.subject | Patients | en |
dc.subject | People and Places | en |
dc.subject | Population Groupings | en |
dc.subject | Sexual Preferences | en |
dc.subject | Men WHO Have Sex with Men | en |
dc.subject | Medical Microbiology | en |
dc.subject | Microbial Pathogens | en |
dc.subject | Viral Pathogens | en |
dc.subject | Immunodeficiency Viruses | en |
dc.subject | HIV | en |
dc.subject | Pathology and Laboratory Medicine | en |
dc.subject | Pathogens | en |
dc.subject | Organisms | en |
dc.subject | Viruses | en |
dc.subject | Biology and life sciences | en |
dc.subject | RNA viruses | en |
dc.subject | Retroviruses | en |
dc.subject | Lentivirus | en |
dc.subject | Infectious diseases | en |
dc.subject | Viral diseases | en |
dc.subject | HIV infections | en |
dc.title | Adherence to Pre-Exposure Prophylaxis for HIV Prevention in a Clinical Setting | en |
dc.type | Journal Article | en_US |
dc.description.version | Version of Record | en |
dc.relation.journal | PLoS ONE | en |
dash.depositing.author | Mayer, Kenneth H. | en_US |
dc.date.available | 2016-08-09T14:54:58Z | |
dc.identifier.doi | 10.1371/journal.pone.0157742 | * |
dash.contributor.affiliated | Mayer, Kenneth | |
dc.identifier.orcid | 0000-0001-7460-733X | |