Adaptation and validation of simple tools to screen and monitor for oral PrEP adherence.

<h4>Introduction</h4>Oral, vaginal and other pre-exposure prophylaxis (PrEP) products for HIV prevention are in various stages of development. Low adherence poses a serious challenge to successful evaluation in trials. In a previous study, we developed tools to screen for general adheren...

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Autores principales:	Seth Zissette, Elizabeth E Tolley, Andres Martinez, Homaira Hanif, Katherine Gill, Nelly Mugo, Laura Myers, Ednar Casmir, Menna Duyver, Kenneth Ngure, Gustavo F Doncel
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/b2d902d873f147d580fad67ae332ba2f
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spelling	oai:doaj.org-article:b2d902d873f147d580fad67ae332ba2f2021-11-25T06:23:45ZAdaptation and validation of simple tools to screen and monitor for oral PrEP adherence.1932-620310.1371/journal.pone.0251823https://doaj.org/article/b2d902d873f147d580fad67ae332ba2f2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0251823https://doaj.org/toc/1932-6203<h4>Introduction</h4>Oral, vaginal and other pre-exposure prophylaxis (PrEP) products for HIV prevention are in various stages of development. Low adherence poses a serious challenge to successful evaluation in trials. In a previous study, we developed tools to screen for general adherence and specifically monitor intravaginal ring adherence within the context of HIV prevention clinical trials. This study aimed to further validate the screening tool and to adapt and provide initial psychometric validation for an oral pill monitoring tool.<h4>Materials and methods</h4>We administered a cross-sectional survey between June and October 2018 at a trial site located near Cape Town, South Africa, and another in Thika, Kenya, with 193 women who had experience using daily oral pills. We fit confirmatory factor analysis models on the screening tool items to assess our previously-hypothesized subscale structure. We conducted an exploratory factor analysis of oral PrEP monitoring items to determine the underlying subscale structure. We then assessed the construct validity of each tool by comparing subscales against each other within the current sample and against our original sample, from a study conducted in four sites in South Africa, including Cape Town.<h4>Results</h4>The screening tool structure showed moderate evidence of construct validity. As a whole, the tool performed in a similar way to the original sample. The monitoring tool items, which were revised to assess perceptions about and experiences using daily oral PrEP, factored into five subscales that showed moderate to good reliability. Four of the five subscales had a similar structure overall to the vaginal ring monitoring tool from which they were adapted.<h4>Conclusions</h4>Accurate measurement of HIV-prevention product adherence is of critical importance to the assessment of product efficacy and safety in clinical trials, and the support of safe and effective product use in non-trial settings. In this study, we provide further validation for these measures, demonstrating the screening tool's utility in additional populations and adapting the monitoring tool's utility for different HIV-prevention products.Seth ZissetteElizabeth E TolleyAndres MartinezHomaira HanifKatherine GillNelly MugoLaura MyersEdnar CasmirMenna DuyverKenneth NgureGustavo F DoncelPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 5, p e0251823 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Seth Zissette Elizabeth E Tolley Andres Martinez Homaira Hanif Katherine Gill Nelly Mugo Laura Myers Ednar Casmir Menna Duyver Kenneth Ngure Gustavo F Doncel Adaptation and validation of simple tools to screen and monitor for oral PrEP adherence.
description	<h4>Introduction</h4>Oral, vaginal and other pre-exposure prophylaxis (PrEP) products for HIV prevention are in various stages of development. Low adherence poses a serious challenge to successful evaluation in trials. In a previous study, we developed tools to screen for general adherence and specifically monitor intravaginal ring adherence within the context of HIV prevention clinical trials. This study aimed to further validate the screening tool and to adapt and provide initial psychometric validation for an oral pill monitoring tool.<h4>Materials and methods</h4>We administered a cross-sectional survey between June and October 2018 at a trial site located near Cape Town, South Africa, and another in Thika, Kenya, with 193 women who had experience using daily oral pills. We fit confirmatory factor analysis models on the screening tool items to assess our previously-hypothesized subscale structure. We conducted an exploratory factor analysis of oral PrEP monitoring items to determine the underlying subscale structure. We then assessed the construct validity of each tool by comparing subscales against each other within the current sample and against our original sample, from a study conducted in four sites in South Africa, including Cape Town.<h4>Results</h4>The screening tool structure showed moderate evidence of construct validity. As a whole, the tool performed in a similar way to the original sample. The monitoring tool items, which were revised to assess perceptions about and experiences using daily oral PrEP, factored into five subscales that showed moderate to good reliability. Four of the five subscales had a similar structure overall to the vaginal ring monitoring tool from which they were adapted.<h4>Conclusions</h4>Accurate measurement of HIV-prevention product adherence is of critical importance to the assessment of product efficacy and safety in clinical trials, and the support of safe and effective product use in non-trial settings. In this study, we provide further validation for these measures, demonstrating the screening tool's utility in additional populations and adapting the monitoring tool's utility for different HIV-prevention products.
format	article
author	Seth Zissette Elizabeth E Tolley Andres Martinez Homaira Hanif Katherine Gill Nelly Mugo Laura Myers Ednar Casmir Menna Duyver Kenneth Ngure Gustavo F Doncel
author_facet	Seth Zissette Elizabeth E Tolley Andres Martinez Homaira Hanif Katherine Gill Nelly Mugo Laura Myers Ednar Casmir Menna Duyver Kenneth Ngure Gustavo F Doncel
author_sort	Seth Zissette
title	Adaptation and validation of simple tools to screen and monitor for oral PrEP adherence.
title_short	Adaptation and validation of simple tools to screen and monitor for oral PrEP adherence.
title_full	Adaptation and validation of simple tools to screen and monitor for oral PrEP adherence.
title_fullStr	Adaptation and validation of simple tools to screen and monitor for oral PrEP adherence.
title_full_unstemmed	Adaptation and validation of simple tools to screen and monitor for oral PrEP adherence.
title_sort	adaptation and validation of simple tools to screen and monitor for oral prep adherence.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/b2d902d873f147d580fad67ae332ba2f
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Adaptation and validation of simple tools to screen and monitor for oral PrEP adherence.

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