학술논문
PrEP uptake and HIV viral suppression when PrEP is integrated into Ugandan ART clinics for HIV-negative members of HIV-serodifferent couples: A stepped wedge cluster randomized trial
Document Type
article
Author
Renee Heffron; Timothy R. Muwonge; Katherine K. Thomas; Florence Nambi; Lylianne Nakabugo; Joseph Kibuuka; Dorothy Thomas; Erika Feutz; Allison Meisner; Norma C. Ware; Monique A. Wyatt; Jane M. Simoni; Ingrid T. Katz; Herbert Kadama; Jared M. Baeten; Andrew Mujugira; Renee Heffron, (protocol chair); Jane Simoni; Deborah Donnell; Ruanne Barnabas; Cole Grabow; Kristin Ciccarelli; Caitlin Scoville; Katrina Ortblad; Mai Nakitende; Diego Izizinga; Vicent Kasita; Brenda Kamusiime; Alisaati Nalumansi; Collins Twesige; Grace Kakoola; Charles Brown; Sylvia Namanda; Emily Pisarski
Source
EClinicalMedicine, Vol 52, Iss , Pp 101611- (2022)
Subject
Language
English
ISSN
2589-5370
Abstract
Summary: Background: Global scale-up of HIV pre-exposure prophylaxis (PrEP) includes services to HIV-negative people in partnerships with people living with HIV (serodifferent couples). Data are needed on HIV outcomes, including uptake and adherence to PrEP and antiretroviral treatment (ART), to describe the impact of integrating PrEP into an existing HIV program. Methods: Using a stepped-wedge cluster randomized trial design, we launched PrEP delivery for HIV-negative members of serodifferent couples in Uganda by integrating PrEP into existing ART programs for people living with HIV. The program provided PrEP training for ART providers, ongoing technical assistance, and a provisional supply chain mechanism for PrEP medication. Primary data on PrEP initiation, PrEP refills, ART initiation, and HIV viremia at 6 months (measured at 42-270 days) were collected through data abstraction of medical records from HIV-serodifferent couples sequentially enrolling at the ART clinics. Modified Poisson regression models, controlling for time and cluster, compared viral suppression (