One-third of patients at an elevated risk for HIV who initiated pre-exposure prophylaxis, or PrEP, in Kenya and Uganda had drug concentrations in hair samples that were consistent with poor adherence, suggesting a need for new approaches and long-acting formulations of this agent, according to a study published in Lancet HIV.

“In generalized epidemic settings, strategies are needed to identify and engage individuals who might benefit from HIV prevention services, including PrEP,” the authors wrote. “Most studies in sub-Saharan Africa have offered PrEP to prespecified populations who are at high risk, such as young women, sex workers and serodifferent couples, who either present to clinical care or are selectively recruited from the community. Comprehensive HIV testing and universal access to PrEP for all people without HIV who are at high risk of infection presents an opportunity to offer PrEP to people who might not otherwise engage in health systems and to assess PrEP engagement at a population level.”

Catherine A. Koss, MD, assistant professor of medicine in the division of HIV, infectious diseases and global medicine at University of California, San Francisco, and colleagues performed a 72-week interim analysis of the ongoing Sustainable East Africa Research in Community Health, or SEARCH, study. They evaluated PrEP uptake within 90 days of HIV testing, program engagement (defined as follow-up visit attendance at weeks 4 and 12 and every 12 weeks thereafter), self-reported adherence up to 72 weeks, refills and concentrations of tenofovir in hair samples from individuals who reported HIV risk and adherence during follow-up. They also examined factors associated with uptake and adherence. Read more via Healio