Female and younger subjects have lower adherence in PrEP trials: a meta-analysis with implications for the uptake of PrEP service to prevent HIV

Author:

Yun Ke,Xu Jun-jie,Zhang Jing,Li Jia-ming,Hu Qing-hai,Chu Zhen-xing,Jiang Yong-jun,Geng Wen-qing,Shang Hong,Wang Ning

Abstract

ObjectiveTo estimate the medicine-taking compliance (MTC) level, explore its facilitators and barriers, and quantify the association between MTC level and pre-exposure prophylaxis (PrEP) protective efficacy in individuals at risk of acquiring HIV being administered oral PrEP.DesignMeta-analysis.Data sourcesWe searched PubMed, Cochrane and Embase databases for published randomized controlled trials (RCTs) pertaining to MTC of oral PrEP for HIV prevention up to 16 January 2017.Review methodsThe pooled proportion of MTC and risk ratio (RR) of HIV incidences between intervention group and control group were estimated.ResultsWe identified 10 eligible studies with 24 193 participants. The overall pooled MTC for oral HIV PrEP was 59.9% (95% CI 43.1% to 74.6%). Subgroup analyses revealed that the MTC level of participants aged <30 years was lower than those equal or older than 30 years (34.9% vs 69.6%, p<0.001); those studies that enrolled only women as participants had lower MTC than those only recruiting either only men or both men and women (31.3% vs 71.7% and 31.3% vs 71.0%, all p<0.01). Additionally, the HIV infection risk increased as the MTC level declines, with the incidence RRs being 0.28 (95% CI 0.19 to 0.41), 0.42 (95% CI 0.29 to 0.62) and 0.75 (95% CI 0.45 to 1.25) in the good (≥80%), moderate (60%~80%) and poor (<60%) MTC subgroups, respectively (linear trend test p<0.01).ConclusionAccording to the pooled proportion, the MTC of oral HIV PrEP is almost moderate, and its proportion in women and younger participants was relatively low. The protective efficacy of oral PrEP for HIV prevention increased with MTC level. These findings indicated that it is necessary to identify measures to enhance MTC of oral PrEP in future clinical usage, especially in women and younger participants with high HIV infection risk.

Publisher

BMJ

Subject

Infectious Diseases,Dermatology

Reference34 articles.

1. UNAIDS. The gap report. 2014 http://files.unaids.org/en/media/unaids/contentassets/docum-ents /unaidspublication/2014/UNAIDS_Gap_report_en.pdf (accessed 15 Dec 2016).

2. CDC. Preexposure prophylaxis for the prevention of HIV infection in the United States-2014: a clinical practice guideline, 2014. https://www.cdc.gov/hiv/pdf/prepguidelines2014.pdf (accessed 15 Dec 2016).

3. Tenofovir-Based Preexposure Prophylaxis for HIV Infection among African Women

4. Preexposure Prophylaxis for HIV Infection among African Women

5. HIV Protective Efficacy and Correlates of Tenofovir Blood Concentrations in a Clinical Trial of PrEP for HIV Prevention

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3