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Adherence to Post-Exposure Prophylaxis for Non-forcible Sexual Exposure to HIV: A Systematic Review and Meta-Analysis |
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| Authors: | Catherine E. Oldenburg Till Bärnighausen Guy Harling Matthew J. Mimiaga Kenneth H. Mayer |
| Affiliation: | 1. Department of Epidemiology, Harvard School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA 2. Department of Global Health and Population, Harvard School of Public Health, Boston, MA, USA 3. Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA 4. Department of Psychiatry, Harvard Medical School/Massachusetts General Hospital, Boston, MA, USA 5. The Fenway Institute, Fenway Health, Boston, MA, USA 6. Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA |
| Abstract: | To characterize adherence to post-exposure prophylaxis after non-forcible sexual exposure to HIV, we conducted a review of the literature and meta-analysis. Articles were considered if they contained primary adherence data following non-forcible sexual exposure. Random-effects meta-analysis was used to create pooled point estimates for adherence. Of 1,257 abstracts identified through our search algorithm, 17 were eligible for inclusion in this review, representing 3,634 patients enrolled in 3 randomized controlled trials (RCTs), 9 prospective and 5 retrospective observational studies. Pooled adherence, primarily assessed by self-report, was 77 % [95 % confidence interval (CI) 68–87] in prospective observational studies, 81 % (95 % CI 65–96) in retrospective studies, 78 % (95 % CI 65–91) in RCTs, and 78 % (95 % CI 72–85) overall. Overall adherence was moderately high, with high variability between studies. Assessment of adherence could be enhanced by the use of objective measurements. |
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