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Adherence to Post-Exposure Prophylaxis for Non-forcible Sexual Exposure to HIV: A Systematic Review and Meta-Analysis

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Abstract

To characterize adherence to post-exposure prophylaxis after non-forcible sexual exposure to HIV, we conducted a review of the literature and meta-analysis. Articles were considered if they contained primary adherence data following non-forcible sexual exposure. Random-effects meta-analysis was used to create pooled point estimates for adherence. Of 1,257 abstracts identified through our search algorithm, 17 were eligible for inclusion in this review, representing 3,634 patients enrolled in 3 randomized controlled trials (RCTs), 9 prospective and 5 retrospective observational studies. Pooled adherence, primarily assessed by self-report, was 77 % [95 % confidence interval (CI) 68–87] in prospective observational studies, 81 % (95 % CI 65–96) in retrospective studies, 78 % (95 % CI 65–91) in RCTs, and 78 % (95 % CI 72–85) overall. Overall adherence was moderately high, with high variability between studies. Assessment of adherence could be enhanced by the use of objective measurements.

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Conflict of interest

None.

Funding

CEO is supported by a NIAID T32 NRSA Grant (T32AI007535; PI: Seage).

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Authors and Affiliations

  1. Department of Epidemiology, Harvard School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA

    Catherine E. Oldenburg & Matthew J. Mimiaga

  2. Department of Global Health and Population, Harvard School of Public Health, Boston, MA, USA

    Till Bärnighausen

  3. Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA

    Guy Harling

  4. Department of Psychiatry, Harvard Medical School/Massachusetts General Hospital, Boston, MA, USA

    Matthew J. Mimiaga

  5. The Fenway Institute, Fenway Health, Boston, MA, USA

    Matthew J. Mimiaga & Kenneth H. Mayer

  6. Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Kenneth H. Mayer

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  1. Catherine E. Oldenburg
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  2. Till Bärnighausen
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  3. Guy Harling
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  4. Matthew J. Mimiaga
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  5. Kenneth H. Mayer
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Corresponding author

Correspondence to Catherine E. Oldenburg.

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Supplementary Table 1

Modified GRADE score assessing quality of included studies (DOCX 37 kb)

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Oldenburg, C.E., Bärnighausen, T., Harling, G. et al. Adherence to Post-Exposure Prophylaxis for Non-forcible Sexual Exposure to HIV: A Systematic Review and Meta-Analysis. AIDS Behav 18, 217–225 (2014). https://doi.org/10.1007/s10461-013-0567-0

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  • DOI: https://doi.org/10.1007/s10461-013-0567-0

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