Sexual relationships outside primary partnerships and abstinence are associated with lower adherence and adherence gaps

Data from the partners PrEP ancillary adherence study

The Partners Ancillary Adherence Study Team

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objective: To assess the role of sexual relationships on levels and patterns of adherence to medication for pre-exposure prophylaxis against HIV. Methods: We enrolled 1147 HIV-negative individuals in long-term serodiscordant relationships at 3 sites in Uganda from the Partners Pre-exposure Prophylaxis Study, a randomized placebo-controlled trial of daily oral tenofovir and emtricitabine/tenofovir. We used generalized estimation equations to assess the effects of sexual relationships on low adherence (<80%) and on gaps in adherence. Results: Fifty-three percent were male, 51% were 18-34 years and 24% were polygamous. Participants who reported sex in the past month with someone other than their primary partner and with <100% condom use were more than twice as likely to have low adherence [adjusted odds ratio (aOR) = 2.48, 95% CI: 1.70 to 3.62] compared with those who had sex with only their primary partners and 100% condom use. Using the same reference group, those who abstained from sex in the previous month had 30% increased odds of low adherence (aOR = 1.30, 95% CI: 1.05 to 1.62) and participants in nonpolygamous marriages who reported sex with both their primary and other partners and <100% condom use were almost twice as likely to be low adherers (aOR = 1.76, 95% CI: 1.01 to 3.08). At least one 72-hour gap in adherence was seen in 598 participants (54.7%); 23.2% had at least one 1-week gap. Conclusions: Risk of low overall adherence was higher in participants who reported sex outside primary partnerships and suboptimal condom use, as well as in those who abstained from sex. Adherence gaps were common, potentially creating risk for HIV acquisition.

Original languageEnglish (US)
Pages (from-to)36-43
Number of pages8
JournalJournal of Acquired Immune Deficiency Syndromes
Volume69
Issue number1
DOIs
StatePublished - May 1 2015
Externally publishedYes

Fingerprint

Tenofovir
Condoms
Odds Ratio
HIV
Uganda
Medication Adherence
Marriage
Randomized Controlled Trials
Placebos
Pre-Exposure Prophylaxis

Keywords

  • adherence
  • Pre-exposure prophylaxis
  • sexual behavior

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Infectious Diseases

Cite this

@article{525206a821824e3ab3c252c7eed3a2e7,
title = "Sexual relationships outside primary partnerships and abstinence are associated with lower adherence and adherence gaps: Data from the partners PrEP ancillary adherence study",
abstract = "Objective: To assess the role of sexual relationships on levels and patterns of adherence to medication for pre-exposure prophylaxis against HIV. Methods: We enrolled 1147 HIV-negative individuals in long-term serodiscordant relationships at 3 sites in Uganda from the Partners Pre-exposure Prophylaxis Study, a randomized placebo-controlled trial of daily oral tenofovir and emtricitabine/tenofovir. We used generalized estimation equations to assess the effects of sexual relationships on low adherence (<80{\%}) and on gaps in adherence. Results: Fifty-three percent were male, 51{\%} were 18-34 years and 24{\%} were polygamous. Participants who reported sex in the past month with someone other than their primary partner and with <100{\%} condom use were more than twice as likely to have low adherence [adjusted odds ratio (aOR) = 2.48, 95{\%} CI: 1.70 to 3.62] compared with those who had sex with only their primary partners and 100{\%} condom use. Using the same reference group, those who abstained from sex in the previous month had 30{\%} increased odds of low adherence (aOR = 1.30, 95{\%} CI: 1.05 to 1.62) and participants in nonpolygamous marriages who reported sex with both their primary and other partners and <100{\%} condom use were almost twice as likely to be low adherers (aOR = 1.76, 95{\%} CI: 1.01 to 3.08). At least one 72-hour gap in adherence was seen in 598 participants (54.7{\%}); 23.2{\%} had at least one 1-week gap. Conclusions: Risk of low overall adherence was higher in participants who reported sex outside primary partnerships and suboptimal condom use, as well as in those who abstained from sex. Adherence gaps were common, potentially creating risk for HIV acquisition.",
keywords = "adherence, Pre-exposure prophylaxis, sexual behavior",
author = "{The Partners Ancillary Adherence Study Team} and Alexander Kintu and Hankinson, {Susan E.} and Raji Balasubramanian and Karen Ertel and Elioda Tumwesigye and David Bangsberg and Haberer, {Jessica E.} and Stephen Safren and Christina Psaros and Norma Ware and Monique Wyatt and Connie Celum and Baeten, {Jared M.} and Deborah Donnell and Craig Hendrix and Stephen Asiimwe and Elly Katabira and Allan Rolland and Edith Nakku-Joloba and James Campbell and Aloysious Kakia",
year = "2015",
month = "5",
day = "1",
doi = "10.1097/QAI.0000000000000538",
language = "English (US)",
volume = "69",
pages = "36--43",
journal = "Journal of Acquired Immune Deficiency Syndromes",
issn = "1525-4135",
publisher = "Lippincott Williams and Wilkins",
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TY - JOUR

T1 - Sexual relationships outside primary partnerships and abstinence are associated with lower adherence and adherence gaps

T2 - Data from the partners PrEP ancillary adherence study

AU - The Partners Ancillary Adherence Study Team

AU - Kintu, Alexander

AU - Hankinson, Susan E.

AU - Balasubramanian, Raji

AU - Ertel, Karen

AU - Tumwesigye, Elioda

AU - Bangsberg, David

AU - Haberer, Jessica E.

AU - Safren, Stephen

AU - Psaros, Christina

AU - Ware, Norma

AU - Wyatt, Monique

AU - Celum, Connie

AU - Baeten, Jared M.

AU - Donnell, Deborah

AU - Hendrix, Craig

AU - Asiimwe, Stephen

AU - Katabira, Elly

AU - Rolland, Allan

AU - Nakku-Joloba, Edith

AU - Campbell, James

AU - Kakia, Aloysious

PY - 2015/5/1

Y1 - 2015/5/1

N2 - Objective: To assess the role of sexual relationships on levels and patterns of adherence to medication for pre-exposure prophylaxis against HIV. Methods: We enrolled 1147 HIV-negative individuals in long-term serodiscordant relationships at 3 sites in Uganda from the Partners Pre-exposure Prophylaxis Study, a randomized placebo-controlled trial of daily oral tenofovir and emtricitabine/tenofovir. We used generalized estimation equations to assess the effects of sexual relationships on low adherence (<80%) and on gaps in adherence. Results: Fifty-three percent were male, 51% were 18-34 years and 24% were polygamous. Participants who reported sex in the past month with someone other than their primary partner and with <100% condom use were more than twice as likely to have low adherence [adjusted odds ratio (aOR) = 2.48, 95% CI: 1.70 to 3.62] compared with those who had sex with only their primary partners and 100% condom use. Using the same reference group, those who abstained from sex in the previous month had 30% increased odds of low adherence (aOR = 1.30, 95% CI: 1.05 to 1.62) and participants in nonpolygamous marriages who reported sex with both their primary and other partners and <100% condom use were almost twice as likely to be low adherers (aOR = 1.76, 95% CI: 1.01 to 3.08). At least one 72-hour gap in adherence was seen in 598 participants (54.7%); 23.2% had at least one 1-week gap. Conclusions: Risk of low overall adherence was higher in participants who reported sex outside primary partnerships and suboptimal condom use, as well as in those who abstained from sex. Adherence gaps were common, potentially creating risk for HIV acquisition.

AB - Objective: To assess the role of sexual relationships on levels and patterns of adherence to medication for pre-exposure prophylaxis against HIV. Methods: We enrolled 1147 HIV-negative individuals in long-term serodiscordant relationships at 3 sites in Uganda from the Partners Pre-exposure Prophylaxis Study, a randomized placebo-controlled trial of daily oral tenofovir and emtricitabine/tenofovir. We used generalized estimation equations to assess the effects of sexual relationships on low adherence (<80%) and on gaps in adherence. Results: Fifty-three percent were male, 51% were 18-34 years and 24% were polygamous. Participants who reported sex in the past month with someone other than their primary partner and with <100% condom use were more than twice as likely to have low adherence [adjusted odds ratio (aOR) = 2.48, 95% CI: 1.70 to 3.62] compared with those who had sex with only their primary partners and 100% condom use. Using the same reference group, those who abstained from sex in the previous month had 30% increased odds of low adherence (aOR = 1.30, 95% CI: 1.05 to 1.62) and participants in nonpolygamous marriages who reported sex with both their primary and other partners and <100% condom use were almost twice as likely to be low adherers (aOR = 1.76, 95% CI: 1.01 to 3.08). At least one 72-hour gap in adherence was seen in 598 participants (54.7%); 23.2% had at least one 1-week gap. Conclusions: Risk of low overall adherence was higher in participants who reported sex outside primary partnerships and suboptimal condom use, as well as in those who abstained from sex. Adherence gaps were common, potentially creating risk for HIV acquisition.

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KW - Pre-exposure prophylaxis

KW - sexual behavior

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U2 - 10.1097/QAI.0000000000000538

DO - 10.1097/QAI.0000000000000538

M3 - Article

VL - 69

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JO - Journal of Acquired Immune Deficiency Syndromes

JF - Journal of Acquired Immune Deficiency Syndromes

SN - 1525-4135

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