Open AccessPoint-of-Care Test for Assessing Tenofovir Adherence: Feasibility and Recommendations from Women in an Oral PrEP Program in Kenya and Their Healthcare Providers
Author(s) -
Nicholas Thuo,
Madison Polay,
Anna M. Leddy,
Kenneth Ngure,
Purba Chatterhee,
Monica Gandhi,
K Rivet Amico
Publication year - 2021
Publication title -
aids and behavior
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.994
H-Index - 106
eISSN - 1573-3254
pISSN - 1090-7165
DOI - 10.1007/s10461-021-03255-3
Subject(s) - formative assessment , psychological intervention , focus group , medicine , context (archaeology) , pre exposure prophylaxis , health care , nursing , qualitative research , family medicine , health psychology , test (biology) , point of care , public health , human immunodeficiency virus (hiv) , psychology , men who have sex with men , paleontology , pedagogy , social science , syphilis , marketing , sociology , economics , business , biology , economic growth
Oral pre-exposure prophylaxis (PrEP) is a highly effective HIV prevention modality when taken as recommended. Women in sub-Saharan Africa may have adherence challenges that remain undisclosed to providers. Real-time measures that identify non-adherence can allow for immediate exploration of adherence challenges, counseling and interventions. We conducted a formative qualitative study in Kenya to explore oral PrEP experiences and reactions to a point-of-care urine test (UT) identifying recent (past 4 days) non-adherence to tenofovir-based PrEP among female PrEP users (25 in-depth interviews; 4 focus groups) and health care provider (10 key informant interviews). Findings indicate that use of the UT would be highly feasible in the context of regular PrEP care, largely acceptable to clients and providers, and could improve adherence. Clients emphasized the need for transparent client-centered strategies in delivering results. This formative study informs the development of tools to implement this point-of-care UT in future interventional studies and clinical settings.