The Effect of Disclosure of PrEP Use on Adherence Among African Young Women in an Open-Label PrEP Study: Findings from HPTN 082

Geetha Beauchamp; Sybil Hosek; Deborah Donnell; Kwun C G Chan; Peter L Anderson; Bonnie J Dye; Nyaradzo Mgodi; Linda-Gail Bekker; Sinead Delany-Moretlwe; Connie Celum; HPTN 082 study team

doi:10.1007/s10461-023-04175-0

The Effect of Disclosure of PrEP Use on Adherence Among African Young Women in an Open-Label PrEP Study: Findings from HPTN 082

AIDS Behav. 2024 May;28(5):1512-1521. doi: 10.1007/s10461-023-04175-0. Epub 2023 Sep 28.

Authors

Geetha Beauchamp^{1

2}, Sybil Hosek³, Deborah Donnell^{4

5}, Kwun C G Chan^{4

6}, Peter L Anderson⁷, Bonnie J Dye⁸, Nyaradzo Mgodi⁹, Linda-Gail Bekker¹⁰, Sinead Delany-Moretlwe¹¹, Connie Celum¹²; HPTN 082 study team

Affiliations

¹ Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA. geetha@scharp.org.
² Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., Mail Stop M2-C200, Seattle, WA, 98109, USA. geetha@scharp.org.
³ Department of Psychiatry, Stroger Hospital of Cook County, Chicago, IL, USA.
⁴ Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA.
⁵ Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., Mail Stop M2-C200, Seattle, WA, 98109, USA.
⁶ Department of Biostatistics, University of Washington, Seattle, WA, USA.
⁷ Department of Pharmaceutical Sciences, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA.
⁸ FHI 360, Durham, NC, USA.
⁹ University of Zimbabwe Clinical Trials Research Centre, Harare, Zimbabwe.
¹⁰ The Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa.
¹¹ Wits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
¹² Departments of Global Health, Medicine, and Epidemiology, University of Washington, Seattle, WA, USA.

Abstract

To develop effective PrEP adherence interventions, it is important to understand the interplay between disclosure of pre-exposure prophalxis (PrEP) use, social support, and PrEP adherence. We leveraged the HPTN 082 study conducted among 451 adolescent girls and young women (AGYW) (ages 16 to 25 years, 2016 to 2019) in South Africa and Zimbabwe. Among the 349 who had month three disclosure and PrEP adherence data, 60% (n = 206) felt supported by adults, and 89% (n = 309) disclosed PrEP use to at least one person. PrEP disclosure was not associated with increased adherence, measured by intracellular tenofovir-diphosphate concentrations in dried blood spots. Women who reported having supportive adults, and disclosed to their parents, had higher adherence at 6 months with an increase of 177 fmol/punch (95% CI 12 to 343, t = 2.11, p = 0.04). PrEP interventions that help AGYW identify supportive relationships and effectively communicate the benefits of PrEP may improve PrEP adherence.Clinicaltrials.gov ID number: NCT02732730.

Keywords: Adherence; Adolescent girls and young women; Africa; Disclosure and social support; HIV prevention; Pre-exposure prophylaxis (PrEP).

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Adenine / analogs & derivatives*
Adolescent
Adult
Anti-HIV Agents* / therapeutic use
Disclosure
Female
HIV Infections* / prevention & control
Humans
Medication Adherence* / psychology
Medication Adherence* / statistics & numerical data
Organophosphates*
Pre-Exposure Prophylaxis* / statistics & numerical data
Social Support*
South Africa
Tenofovir / therapeutic use
Young Adult
Zimbabwe

Substances

Anti-HIV Agents
Tenofovir
tenofovir diphosphate
Adenine
Organophosphates

Associated data

ClinicalTrials.gov/NCT02732730

Grants and funding

UM1-AI068617/Division of Intramural Research, National Institute of Allergy and Infectious Diseases