Self-reported Recent PrEP Dosing and Drug Detection in an Open Label PrEP Study.

Area of Science:

• Public Health
• Pharmacology
• Clinical Trials

Background:

• Monitoring adherence to pre-exposure prophylaxis (PrEP) is crucial for effective HIV prevention.
• Discrepancies between reported and actual PrEP use in clinical trials raise concerns about adherence monitoring methods.

Purpose of the Study:

• To evaluate the concordance between self-reported recent PrEP dosing and objective drug quantitation.
• To assess the reliability of neutral interviewing for monitoring PrEP adherence.

Main Methods:

• The study analyzed data from the iPrEx open-label extension, including 1172 participants.
• Concordance was assessed between self-reported recent PrEP dosing (past 3 days) via neutral interviewing and quantifiable drug levels.
• Predictors of over-reporting adherence were identified.

Main Results:

• 84% of participants reported recent PrEP dosing, and 83% of these had quantifiable drug levels.
• 82% of participants reporting no recent PrEP doses did not have quantifiable drug levels.
• Younger age and lower educational attainment predicted over-reporting of PrEP use.

Conclusions:

• Neutral interviewing demonstrates potential as a reliable method for clinicians to monitor recent PrEP use.
• Further strategies are needed to accurately assess long-term or prevention-effective PrEP use, especially in younger populations.