Adaptive HIV pre-exposure prophylaxis adherence interventions for young women in Johannesburg, South Africa: a sequential multiple-assignment randomised trial

作者：Jennifer Velloza, Nicole Poovan, Allison Meisner, Nontokozo Ndlovu, Nomhle Ndimande‐Khoza, Cole Grabow, Phumzile Zwane, Samukelo Mbele, Mapaseka Molefe, Deborah Donnell, Jared M. Baeten, Sybil Hosek, Connie Celum, Sinead Delany‐Moretlwe · 发表于：The Lancet HIV · 年份：2024 · DOI：10.1016/s2352-3018(24)00268-6 · 被引用次数：10 · 研究领域：HIV/AIDS Research and Interventions、Mobile Health and mHealth Applications、Adolescent Sexual and Reproductive Health

BACKGROUND: Adherence to daily oral pre-exposure prophylaxis (PrEP) is low among African young women, and layered support strategies are needed to improve PrEP adherence in this population. We aimed to evaluate potentially scalable adherence-support strategies for young women aged 18-25 years who initiated PrEP in Johannesburg, South Africa. METHODS: We conducted a sequential multiple-assignment randomised trial at Ward 21 of the Wits Reproductive Health and HIV Institute clinical research site, affiliated with University of the Witwatersrand, Johannesburg, South Africa. Participants were eligible if they were assigned female sex at birth, aged 18-25 years, not living with HIV, sexually active, newly initiating PrEP, had regular access to a mobile telephone, and could read. Using sequentially numbered, sealed, opaque envelopes containing group allocation, a staff member assigned enrolled participants (1:1) to receive one of two adherence-support interventions: once per week two-way SMS communication or participation in a WhatsApp peer-support group. Participants assigned to WhatsApp were put into groups with approximately 25 participants, during which they were prompted by staff facilitators to discuss any challenges with PrEP use or other events happening in their lives. The allocation sequence was generated by the data manager using random numbers with variable block sizes between 10 and 14. Only trial investigators were masked to participant intervention assignments; parti...