Antiretroviral Adherence Measurement in HIV Prevention
Summary
Accurate assessment of adherence to antiretroviral regimens underpins the success of HIV prevention strategies, notably pre-exposure prophylaxis (PrEP). Traditional self-reporting methods, while simple and inexpensive, suffer from recall bias and social desirability effects, often overestimating true drug intake. In response, objective pharmacokinetic biomarkers have been adopted, measuring drug or metabolite concentrations in biological matrices that reflect recent or cumulative exposure. Short-term metrics include plasma or urine levels of tenofovir, while long-term metrics use dried blood spots (DBS), peripheral blood mononuclear cells and hair samples, each capturing different windows of drug ingestion. Emerging point-of-care assays now permit real-time feedback, facilitating adherence counselling at clinical visits. Integration of multiple adherence measures offers a more nuanced profile of drug use, guiding tailored interventions and minimising the risk of HIV acquisition.
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Antiretroviral Adherence Measurement in HIV Prevention publication trend
The graph below shows the total number of articles in antiretroviral adherence measurement in hiv prevention across all publications each year (not limited to Nature Index journals).
Technical terms
Pre-exposure prophylaxis (PrEP): Administration of antiretroviral drugs to HIV-negative individuals to prevent viral acquisition.
Pharmacokinetic biomarker: Quantifiable drug concentration in a biological fluid or tissue that reflects timing and consistency of dosing.
Dried blood spot (DBS): Capillary blood collected on filter paper, providing a long-term record of drug exposure.
Point-of-care assay: A diagnostic test performed during the patient encounter, yielding rapid results to inform clinical decisions.
References
- Impact of a point-of-care urine tenofovir assay on adherence to HIV pre-exposure prophylaxis among women in Kenya: a randomised pilot trial. The Lancet HIV (2024).
- Type 1 Human Immunodeficiency Virus (HIV-1) Incidence, Adherence, and Drug Resistance in Individuals Taking Daily Emtricitabine/Tenofovir Disoproxil Fumarate for HIV-1 Pre-exposure Prophylaxis: Pooled Analysis From 72 Global Studies. Clinical Infectious Diseases (2024).
- Discrepancies between self-reported medication in adherence and indirect measurement adherence among patients undergoing antiretroviral therapy: a systematic review. Infectious Diseases of Poverty (2024).
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