Association between substance use and PrEP adherence among adolescent girls and young women enrolled in an HIV prevention study in Southern Africa

作者：Kudzai Hlahla, Rahul Paul Choudhury, Bekezela Siziba, Peter L. Anderson, Sinéad Delany‐Moretlwe, Theodorah Rirhandzu Ndzhukule, Sybil Hosek, Nyaradzo Mgodi, for the on behalf of the HPTN 082 Study Team · 发表于：PLOS Global Public Health · 年份：2025 · DOI：10.1371/journal.pgph.0004750 · 被引用次数：3 · 研究领域：HIV/AIDS Research and Interventions、HIV, Drug Use, Sexual Risk、Adolescent Sexual and Reproductive Health

Adolescent girls and young women (AGYW) in sub-Saharan Africa are at substantial risk of HIV acquisition and could benefit from oral pre-exposure prophylaxis (PrEP) for HIV prevention. Substance use may result in poor adherence, diminishing PrEP effectiveness. The effects of substance use on PrEP adherence in AGYW within the African context have not been extensively studied. We sought to determine the prevalence of substance use and its association with PrEP adherence in AGYW enrolled in an HIV prevention trial. The HIV Prevention Trials Network (HPTN) 082 study enrolled healthy, HIV-negative, sexually active young women (16-25 years) from Cape Town, Johannesburg, South Africa, and Harare, Zimbabwe, between October 2016-2018. Participants were offered oral PrEP. Data on hazardous drinking was collected using the AUDIT-C questionnaire and defined as having an AUDIT-C score ≥3. Data on substance use was collected using the abridged ASSIST questionnaire, with responses categorized as 0 (never used a substance) and 1 (ever substance use). Tenofovir-diphosphate (TFV-DP) levels in dried blood spots at weeks 13, 26, and 52 were used to measure PrEP adherence. Low adherence was defined as TFV-DP concentration <700 fmol/punch. Repeated measure multinomial regression modeling was used to determine associations between substance use and hazardous drinking vs PrEP adherence. Of the 451 participants enrolled, 427 (95%) initiated PrEP. The prevalence of hazardous drinking and substance use...