Observational studyJournal of acquired immune deficiency syndromes (1999)2016
PrEP Adherence Patterns Strongly Affect Individual HIV Risk and Observed Efficacy in Randomized Clinical Trials.
Observational study in Journal of acquired immune deficiency syndromes (1999), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
40 citing papers in PubMed, 3 syntheses or guidelines pooled it, 50 citations in OpenAlex.
- Evolving landscape of economic evaluations of HIV pre-exposure prophylaxis and pre-exposure prophylaxis implementation strategies: a systematic review.Journal of the International AIDS Society · 2025Pooled it
- A Community Guide Systematic Review: Digital HIV Pre-Exposure Prophylaxis Interventions.American journal of preventive medicine · 2024Pooled it
- In what circumstances could nondaily preexposure prophylaxis for HIV substantially reduce program costs?AIDS (London, England) · 2018Pooled it
- Trial
- Trial
- Safety and Pharmacokinetics of Monoclonal Antibodies VRC07-523LS and PGT121 Administered Subcutaneously for Human Immunodeficiency Virus Prevention.The Journal of infectious diseases · 2022Trial
- Trial
- HIV-1 genetic diversity to estimate time of infection and infer adherence to preexposure prophylaxis.AIDS (London, England) · 2019Trial
- A Conversational Agent for Providing Personalized Preexposure Prophylaxis (PrEP) Support: Protocol for Chatbot Implementation and Evaluation.JMIR research protocols · 2026Article
- Guiding principles for pragmatic randomised trials of tuberculosis treatments.The Lancet. Infectious diseases · 2026Review
- Epidemiologic Impact of Prioritizing Long-Acting Injectable Cabotegravir to Men Who Have Sex With Men With Low Pre-Exposure Prophylaxis Use Adherence in the Netherlands: A Mathematical Modeling Study.Journal of acquired immune deficiency syndromes (1999) · 2026Article
- A qualitative study on pre-exposure prophylaxis uptake and retention among men who have sex with men and transgender women in Myanmar.International health · 2026Article
- Let Them Talk: Coping with PrEP-Related Stigma and Sustaining PrEP Persistence Among Men Who Have Sex with Men in Tanga, Tanzania.Healthcare (Basel, Switzerland) · 2026Article
- Indirect Treatment Comparison of Long-Acting Injectable Cabotegravir as Pre-exposure Prophylaxis When Compared with no Pre-exposure Prophylaxis for HIV Prevention.Infectious diseases and therapy · 2025Article
- Cost-effectiveness of HIV pre-exposure prophylaxis among female sex workers in Iran.Scientific reports · 2025Article
- Retention in HIV Pre-Exposure Prophylaxis Among Men Who Have Sex with Men in Tanga, Tanzania.HIV/AIDS (Auckland, N.Z.) · 2025Article
- Estimating the effect of pre-exposure prophylaxis in Black men who have sex with men.International journal of epidemiology · 2024Article
- Weekly Oral Tenofovir Alafenamide Protects Macaques from Vaginal and Rectal Simian HIV Infection.Pharmaceutics · 2024Article
- Pre-Exposure Prophylaxis and HIV Prevention Among Key Populations in Nigeria.International journal of MCH and AIDS · 2024Article
- Enhancing daily oral PrEP adherence with digital communications: Protocol for a systematic review and meta-analysis.PloS one · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundRandomized controlled trials (RCTs) suggest that the efficacy of tenofovir-based preexposure prophylaxis (PrEP) strongly depends on the consistency of PrEP use. We explore how the patterns of pill taking and waning of PrEP protection may affect PrEP efficacy for HIV prevention.
methodsA 2-arm RCT was simulated by mathematical models assuming that the prescribed daily doses were skipped periodically, randomly, or in large blocks. Risk-driven adherence, in which PrEP was taken when sex was expected, was also investigated. Three temporal PrEP protection profiles were explored: long (5 days), intermediate (3 days), and short (24 hours). Modeling results were compared to the efficacy observed in completed RCTs.
resultsThe expected PrEP efficacy was 60% with periodic, 50% with random, and 34% with block adherence when PrEP had a long protection profile and pills were taken only 50% of the days. Risk-driven pill taking resulted in 29% and 37% daily pills taken and efficacy of 43% and 51%, respectively, for long protection. High PrEP efficacy comparable with that observed in Partners PrEP and Centers for Disease Control and Prevention Botswana trials was simulated under long protection, high overall adherence, and limited block pill taking; the moderate efficacy observed in iPrEx and Bangkok trials was comparable with the 50% adherence scenarios under random pill taking and long protection.
conclusionsPill-taking patterns may have a substantial impact on the protection provided by PrEP even when the same numbers of pills are taken. When PrEP retains protection for longer than a day, pill-taking patterns can explain a broad range of efficacies observed in PrEP RCTs.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.