Measuring Adherence to HIV Prevention in Adolescents
Author Information
Author(s): Diana Zeballos, Laio Magno, Fabiane Soares, Jony Arrais Pinto Junior, Leila Amorim, Dirceu Greco, Alexandre Grangeiro, Inês Dourado
Primary Institution: Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil
Hypothesis
Indirect adherence measures can effectively assess PrEP adherence among adolescents at risk for HIV.
Conclusion
Indirect measures can identify adolescents with good adherence to PrEP, but may struggle to detect those with low adherence.
Supporting Evidence
- The study included 302 samples from 188 participants.
- Self-report adherence showed high sensitivity (92%) but low specificity (46%).
- Combining medication possession ratio and self-report improved adherence discrimination (AUC = 0.77).
Takeaway
This study looked at how well different ways of checking if young people are taking their HIV prevention medicine work. Some methods are better at showing if they are taking it regularly.
Methodology
A diagnostic accuracy study was conducted using tenofovir-diphosphate concentrations in dried blood spots as the reference standard, along with three index tests: medication possession ratio, pill count, and self-report.
Potential Biases
Social desirability bias may affect self-reported adherence.
Limitations
The study's reliance on self-reported adherence may introduce bias, and the sample size for some measures was limited.
Participant Demographics
Participants were predominantly adolescent men who have sex with men (78.7%), aged 18-19 years (80.3%), and non-white (72.9%).
Digital Object Identifier (DOI)
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