Development of a tool to assess HIV prevention readiness of adolescent girls and young women in HPTN 082 study.
<h4>Background</h4>African adolescent girls and young women (AGYW) represent a large proportion of new HIV infections, a priority population for pre-exposure prophylaxis (PrEP), but adherence remains a challenge. A reliable, valid readiness tool would help identify AGYW motivated to take...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2023-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0281728 |
| _version_ | 1797801992959033344 |
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| author | Geetha Beauchamp Sybil Hosek Deborah J Donnell Kwun C G Chan Brian P Flaherty Peter L Anderson Bonnie J Dye Nyaradzo Mgodi Linda-Gail Bekker Sinead Delany-Moretlwe Connie Celum HPTN 082 study team |
| author_facet | Geetha Beauchamp Sybil Hosek Deborah J Donnell Kwun C G Chan Brian P Flaherty Peter L Anderson Bonnie J Dye Nyaradzo Mgodi Linda-Gail Bekker Sinead Delany-Moretlwe Connie Celum HPTN 082 study team |
| author_sort | Geetha Beauchamp |
| collection | DOAJ |
| description | <h4>Background</h4>African adolescent girls and young women (AGYW) represent a large proportion of new HIV infections, a priority population for pre-exposure prophylaxis (PrEP), but adherence remains a challenge. A reliable, valid readiness tool would help identify AGYW motivated to take PrEP who need adherence support.<h4>Methods</h4>In the HPTN 082 open-label PrEP study (2016-2019), South African and Zimbabwean women ages 16-25 were administered an HIV prevention readiness measure (HPRM). The 25 items in the HPRM included medication beliefs, connection with care, disclosure of PrEP use, social support, and housing stability using a 5-point Likert scale. Exploratory factor analysis (EFA) using polychoric correlations, scale reliability, and predictive validity were performed on data from 315 participants who responded to all items. We assessed the predictive value of HPRM scores with PrEP adherence, defined as tenofovir-diphosphate (TFV-DP) concentrations in dried blood spots, as a continuous measure and dichotomized as high PrEP adherence (≥700 fmol/punch).<h4>Results</h4>EFA yielded 23 items with three subscales: self-efficacy (16 items), PrEP disclosure (4 items), and social support (3 items). Cronbach's α ranged from 0.71 to 0.92 for the overall scale and the subscales. The average overall scale and the subscales were predictive of 3-month PrEP adherence for TFV-DP concentrations: for each unit increase of the HPRM score, TFV-DP concentration increased by 103 fmol/punch (95% CI: 16, 189, p = 0.02); the highest HPRM score equated with 608 fmol/punch on average. For the self-efficacy subscale, TFV-DP increased by 90 fmol/punch (95% CI: 7, 172, p = 0.03); PrEP disclosure, 68 fmol/punch (95% CI: 19, 117 p = 0.01); and social support, 58fmol/punch (95% CI: 2, 113, p = 0.04). Higher PrEP disclosure suggests high adherence (OR 1.36, 95% CI: 1.00, 1.86, p = 0.05) and predicted persistent high adherence at both months three and six (OR: 1.50, 95% CI: 1.03, 2.21, p = 0.04).<h4>Conclusions</h4>The HPRM scale overall and the subscales individually demonstrated good internal consistency among African young women. PrEP disclosure subscale exhibiting significant association with persistent high PrEP adherence is an important finding for PrEP adherence support programs. Future work will assess replicability and expand self-efficacy and social-support subscales after item revision.<h4>Trial registration</h4>ClinicalTrials.gov NCT02732730. |
| first_indexed | 2024-03-13T04:59:00Z |
| format | Article |
| id | doaj.art-abbdebb8d6c149b692805cb25958e077 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-03-13T04:59:00Z |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-abbdebb8d6c149b692805cb25958e0772023-06-17T05:32:08ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01182e028172810.1371/journal.pone.0281728Development of a tool to assess HIV prevention readiness of adolescent girls and young women in HPTN 082 study.Geetha BeauchampSybil HosekDeborah J DonnellKwun C G ChanBrian P FlahertyPeter L AndersonBonnie J DyeNyaradzo MgodiLinda-Gail BekkerSinead Delany-MoretlweConnie CelumHPTN 082 study team<h4>Background</h4>African adolescent girls and young women (AGYW) represent a large proportion of new HIV infections, a priority population for pre-exposure prophylaxis (PrEP), but adherence remains a challenge. A reliable, valid readiness tool would help identify AGYW motivated to take PrEP who need adherence support.<h4>Methods</h4>In the HPTN 082 open-label PrEP study (2016-2019), South African and Zimbabwean women ages 16-25 were administered an HIV prevention readiness measure (HPRM). The 25 items in the HPRM included medication beliefs, connection with care, disclosure of PrEP use, social support, and housing stability using a 5-point Likert scale. Exploratory factor analysis (EFA) using polychoric correlations, scale reliability, and predictive validity were performed on data from 315 participants who responded to all items. We assessed the predictive value of HPRM scores with PrEP adherence, defined as tenofovir-diphosphate (TFV-DP) concentrations in dried blood spots, as a continuous measure and dichotomized as high PrEP adherence (≥700 fmol/punch).<h4>Results</h4>EFA yielded 23 items with three subscales: self-efficacy (16 items), PrEP disclosure (4 items), and social support (3 items). Cronbach's α ranged from 0.71 to 0.92 for the overall scale and the subscales. The average overall scale and the subscales were predictive of 3-month PrEP adherence for TFV-DP concentrations: for each unit increase of the HPRM score, TFV-DP concentration increased by 103 fmol/punch (95% CI: 16, 189, p = 0.02); the highest HPRM score equated with 608 fmol/punch on average. For the self-efficacy subscale, TFV-DP increased by 90 fmol/punch (95% CI: 7, 172, p = 0.03); PrEP disclosure, 68 fmol/punch (95% CI: 19, 117 p = 0.01); and social support, 58fmol/punch (95% CI: 2, 113, p = 0.04). Higher PrEP disclosure suggests high adherence (OR 1.36, 95% CI: 1.00, 1.86, p = 0.05) and predicted persistent high adherence at both months three and six (OR: 1.50, 95% CI: 1.03, 2.21, p = 0.04).<h4>Conclusions</h4>The HPRM scale overall and the subscales individually demonstrated good internal consistency among African young women. PrEP disclosure subscale exhibiting significant association with persistent high PrEP adherence is an important finding for PrEP adherence support programs. Future work will assess replicability and expand self-efficacy and social-support subscales after item revision.<h4>Trial registration</h4>ClinicalTrials.gov NCT02732730.https://doi.org/10.1371/journal.pone.0281728 |
| spellingShingle | Geetha Beauchamp Sybil Hosek Deborah J Donnell Kwun C G Chan Brian P Flaherty Peter L Anderson Bonnie J Dye Nyaradzo Mgodi Linda-Gail Bekker Sinead Delany-Moretlwe Connie Celum HPTN 082 study team Development of a tool to assess HIV prevention readiness of adolescent girls and young women in HPTN 082 study. PLoS ONE |
| title | Development of a tool to assess HIV prevention readiness of adolescent girls and young women in HPTN 082 study. |
| title_full | Development of a tool to assess HIV prevention readiness of adolescent girls and young women in HPTN 082 study. |
| title_fullStr | Development of a tool to assess HIV prevention readiness of adolescent girls and young women in HPTN 082 study. |
| title_full_unstemmed | Development of a tool to assess HIV prevention readiness of adolescent girls and young women in HPTN 082 study. |
| title_short | Development of a tool to assess HIV prevention readiness of adolescent girls and young women in HPTN 082 study. |
| title_sort | development of a tool to assess hiv prevention readiness of adolescent girls and young women in hptn 082 study |
| url | https://doi.org/10.1371/journal.pone.0281728 |
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