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Review
. 2013 Jul;17(6):2143-55.
doi: 10.1007/s10461-013-0429-9.

Adherence support approaches in biomedical HIV prevention trials: experiences, insights and future directions from four multisite prevention trials

K Rivet Amico  1 , Leila E Mansoor, Amy Corneli, Kristine Torjesen, Ariane van der Straten
Affiliations
Review

Adherence support approaches in biomedical HIV prevention trials: experiences, insights and future directions from four multisite prevention trials

K Rivet Amico et al. AIDS Behav. 2013 Jul.

Abstract
in English, Spanish

Adherence is a critical component of the success of antiretroviral-based pre-exposure prophylaxis (PrEP) in averting new HIV-infections. Ensuring drug availability at the time of potential HIV exposure relies on self-directed product use. A deeper understanding of how to best support sustained PrEP adherence remains critical to current and future PrEP efforts. This paper provides a succinct synthesis of the adherence support experiences from four pivotal PrEP trials--Centre for the AIDS Programme of Research in South Africa (CAPRISA) 004, FEM-PrEP, Iniciativa Prophylaxis (iPrEx), and Vaginal and Oral Interventions to Control the Epidemic (VOICE). Notwithstanding variability in the design, population/cohort, formulation, drug, dosing strategy, and operationalization of adherence approaches utilized in each trial, the theoretical basis and experiences in implementation and monitoring of the approaches used by these trials provide key lessons for optimizing adherence in future research and programmatic scale-up of PrEP. Recommendations from across these trials include participant-centered approaches, separating measurement of adherence from adherence counseling, incorporating tailored strategies that go beyond education, fostering motivation, and addressing the specific context in which an individual incorporates and negotiates PrEP use.

La adherencia al producto es un componente crítico para el éxito de la pre-exposición profiláctica (PrEP, siglas en inglés) basada en antirretrovirales para prevenir nuevas infecciones del VIH. Asegurar la presencia del medicamento cuando existe la posibilidad de exposición al VIH depende en el uso autodirigido del producto. Un mejor entendimiento de cómo mejor apoyar adherencia sostenida a PrEP sigue siendo crítico en los esfuerzos presentes y futuros de PrEP. Este papel provee un sucinto resumen de las experiencias de apoyo a la adherencia de cuatro estudios esenciales -CAPRISA 004 (Centre for the AIDS Programme of Research in South Africa, FEMPrEP, Iniciativa Prophylaxis (iPrEX), y VOICE (Vaginal and Oral Interventions to Control the Epidemic). A pesar de la variaciones en los diseños, poblaciones/cohortes, fórmulas, drogas/medicamentos, estrategias de dosis y operacionalización de enfoques de adherencia utilizadas en cada estudio, las bases teóricas y experiencias en implementación y monitoreo de los enfoques utilizados por estos estudios proveen lecciones claves para optimizar la adherencia en futuros estudios y la ampliación programática de PrEP. Las recomendaciones de todos estos estudios incluyen enfoques centralizados en los participantes, separando medidas de adherencia de la consejería sobre la adherencia, incorporando estrategias adaptadas que van mas allá de la educación, fomentando la motivación y dirigiendo el contexto específico en el cual un individuo incorpora y se adapta al uso de PrEP.

Trial registration: ClinicalTrials.gov NCT00458393.

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Figures

Fig. 1
Fig. 1
Steps and framing of the ASP
Fig. 2
Fig. 2
Steps and framing of NSC
Fig. 3
Fig. 3
Steps and framing of VASP
See this image and copyright information in PMC

References

    1. Abdool Karim Q, Abdool Karim SS, Frohlich JA, Grobler AC, Baxter C, Mansoor LE, et al. Effectiveness and safety of tenofovir gel, an antiretroviral microbicide, for the prevention of HIV infection in women. Science. 2010;329(5996):1168–74. - PMC - PubMed
    1. Baeten JM, Donnell D, Ndase P, Mugo NR, Campbell JD, Wangisi J, Tappero JW, Bukusi EA, Cohen CR, Katabira E, Ronald A, Tumwesigye E, Were E, Fife KH, Kiarie J, Farquhar C, John-Stewart G, Kakia A, Odoyo J, Mucunguzi A, Nakku-Joloba E, Twesigye R, Ngure K, Apaka C, Tamooh H, Gabona F, Mujugira A, Panteleeff D, Thomas KK, Kidoguchi L, Krows M, Revall J, Morrison S, Haugen H, Emmanuel-Ogier M, Ondrejcek L, Coombs RW, Frenkel L, Hendrix C, Bumpus NN, Bangsberg D, Haberer JE, Stevens WS, Lingappa JR, Celum C, the Partners PrEP Study Team. Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. N Engl J Med. 2012;367(5):399–410. - PMC - PubMed
    1. Grant RM, Lama JR, Anderson PL, McMahan V, Liu AY, Vargas L, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010;363(27):2587–99. - PMC - PubMed
    1. Thigpen MC, Kebaabetswa PM, Paxton L, Smith DK, Rose CE, Segolodi TM, Henderson FL, Pathak SR, Soud FA, Chillag K, Mutanhaurwa R, Chirwa LI, Kasonde M, Abebe D, Buliva E, Gvetadze R, Johnson S, Sukalac T, Thomas VT, Hart C, Johnson JA, Malotte CK, Hendrix CW, Brooks JT, for the TDF2 Study Group. Antiretroviral preexposure prophylaxis for heterosexual HIV transmission in Botswana. N Engl J Med. 2012. doi:10.1056/NEJMoa1110711. - PubMed
    1. Van Damme L, Corneli A, Ahmed K, et al. Preexposure prophylaxis for HIV infection among African women. N Engl J Med. 2012;367(5):411–22. - PMC - PubMed

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