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ADAPT Study Results Show Daily Oral PrEP Adherence among Key Populations in Harlem

July 30, 2015

Results from the HPTN 067 study conducted at ICAP’s Harlem Prevention Center among other sites supported by the HIV Prevention Trials Network, reveal that men who have sex with men (MSM) and transgender women (TGW) at high risk of contracting HIV were able to adhere to a daily pre-exposure prophylaxis (PrEP) regimen to prevent HIV. The findings, which were shared at the 8th International AIDS Society Conference in Vancouver, Canada, are encouraging and indicate that populations at high risk for HIV are more likely to adhere to daily dosing versus non-daily dosing regimens of oral PrEP, currently available as Truvada®.

Funded by the National Institutes of Health (NIH), HPTN 067, also known as the Alternative Dosing to Augment Pre-Exposure Prophylaxis Pill Taking or ADAPT study, was designed to identify which PrEP pill-taking schedules participants might be more likely to follow. The study looked at the acceptability and use of three different dosing schedules—daily; twice weekly with a dose after sex; and one dose before and another after sex. The study followed more than 500 participants at three sites, women in Cape Town, South Africa, and MSM and transgender women in Bangkok, Thailand, and Harlem, N.Y.

In Harlem, where 179 black MSM and transgender women took part in the study at the Harlem Prevention Center, researchers measured adherence through self-reporting, blood analysis, and electronic monitoring data from pillboxes that record each time the box is opened.

“Members of the US black MSM community are disproportionally impacted by HIV,” said Dr. Sharon Mannheimer, site principal investigator at Harlem Prevention Center. “These results are especially important in demonstrating that this population can adhere to PrEP when given access to it.”

The study also included a qualitative component where study participants were asked to share their views and experiences with PrEP, adherence, and the study overall. The qualitative sub-study was conducted with 37 men in Harlem where HPTN 067 participants revealed that they encountered skepticism and distrust by partners and sometimes unwillingness of their partners to engage in sex after learning about their PrEP use. Despite broad consensus among public health experts about the benefits of PrEP, the qualitative study results offer a glimpse into how stigma and other social barriers may impede adherence.

“This sub-study highlights the importance of community-level education to build social support for taking PrEP,” said Dr. Julie Franks, study coordinator, Harlem Prevention Center. “Interventions to address HIV-related stigma in the context of taking PrEP are needed for black MSM, who make up the group most heavily impacted by HIV in the U.S.”

ICAP’s work in the United States focuses primarily on HIV prevention research, with six current studies to identify effective new HIV prevention methods for populations at risk in the US.