Spotlight Center on HIV Prevention Today


People With Housing and Higher HIV Risk Are More Adherent to PrEP

July 22, 2015

Albert Liu, M.D., M.P.H.

Albert Liu, M.D., M.P.H.

BETA is attending and reporting from the 2015 International AIDS Society Conference on HIV Pathogenesis, Treatment & Prevention this week in Vancouver -- bringing you the latest news, updates, and research on HIV treatment and prevention.

Final results from a PrEP demonstration project held in three large U.S. cities were announced yesterday during the International AIDS Conference in Vancouver. The study, which enrolled 557 HIV-negative men who have sex with men and transgender women started enrolling participants shortly after the FDA approved Truvada-based PrEP in the U.S. in 2012. Albert Liu, MD, MPH, from the San Francisco Department of Public Health, presented findings demonstrating high adherence to the daily Truvada PrEP regimen among study participants, stable (although high) STI rates throughout the study, and low HIV incidence.

"Our results strongly support the scale-up of PrEP in clinical settings," said Liu during an IAS press conference.

The study intentionally enrolled people likely to be at high-risk of HIV acquisition. At baseline, more than two-thirds of participants reported having condomless receptive anal sex in the past three months and almost a quarter reported having a partner living with HIV. More than a quarter were diagnosed with an STI at baseline.


Over the course of the 12-month study, the researchers measured how adherent participants were to the daily PrEP dosing regimen using three methods: dried blood spot analysis (a measure of the drug in the bloodstream), self-reported adherence and a ratio of medication dispensed and medication returned to the site at each visit (medication possession ratio).

"Overall, we saw high levels of PrEP adherence in our study," said Liu.

Retention in the study remained relatively high, with 88% of participants returning for the 3-month follow-up visit, 85% at 6 months, and 78% at 12 months.

Adherence to the PrEP drug, as measured by dried blood spot analysis, remained high over the course of the study, with adherence ranging from 80% to 85%. Self-reported adherence followed a similar pattern as did medication possession measures (with a slight dip at the last visit). Liu shared that 63% of PrEP demo project participants had protective drug levels detected from dried blood spot analysis at all study visits, while only 3% had drug levels consistent with less than two doses per week at all visits.

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