TABLE 3.
Predictors of High (5+ Doses/Week) Electronically Monitored PrEP Adherence
| N participant Visits (%) or Mean (SD) | Unadjusted Odds Ratio (95% CI) | P | Adjusted Odds Ratio (95% CI) | P | |
| Individual factors | |||||
| Baseline VOICE risk score | 6 (1) | 0.75 (0.62 to 0.92) | 0.005 | 0.73 (0.58 to 0.91) | 0.006 |
| Age at baseline (yr) | 21 (2) | 0.99 (0.91 to 1.10) | 0.95 | — | — |
| Education (yr) | 11 (2) | 0.92 (0.86 to 0.98) | 0.015 | 0.94 (0.87 to 1.02) | 0.12 |
| Possible depression | 6 (13%) | 0.64 (0.27,1.50) | 0.30 | — | — |
| Low self-esteem | 4 (10%) | 0.41 (0.06 to 2.6) | 0.35 | — | — |
| Problematic alcohol use | 20 (14%) | 1.04 (0.67 to 1.61) | 0.86 | — | — |
| Prior daily medication use | 55 (19%) | 0.80 (0.49 to 1.32) | 0.39 | — | — |
| Perceived necessity for PrEP | 0.82 | ||||
| Low (1–1.8) | 75 (21%) | Ref | |||
| Moderate (1.9–2.1) | 156 (22%) | 0.98 (0.67 to 1.43) | |||
| High (2.1–4.0) | 154 (19%) | 0.89 (0.58 to 1.37) | |||
| Concerns about taking PrEP | 0.30 | ||||
| Low (2.4–3.5) | 110 (20%) | Ref | |||
| Moderate (3.6–3.9) | 164 (22%) | 0.91 (0.67 to 1.25) | |||
| High (4.0–5.0) | 111 (18%) | 0.73 (0.49 to 1.09) | |||
| Risk attitude | 0.29 | ||||
| Low tolerance for risk | 133 (21%) | Ref | |||
| Moderate tolerance for risk | 152 (20%) | 1.07 (0.74 to 1.56) | |||
| High tolerance for risk | 99 (20%) | 1.19 (0.80 to 1.79) | |||
| Partnership factors | |||||
| Any HIV+ partner | 33 (32%) | 1.16 (0.64 to 2.13) | 0.62 | — | — |
| > 1 current sexual partner | 96 (21%) | 1.00 (0.99 to 1.01) | 0.90 | 1.82 (1.32 to 2.51) | <0.001 |
| Condomless sex | 203 (20%) | 1.11 (0.87 to 1.42) | 0.39 | — | — |
| Sexual relationship power* | 0.06 | 0.06 | |||
| Low (1.0–2.4) | 41 (14%) | Ref | |||
| Moderate (2.5–2.8) | 168 (23%) | 1.51 (1.06 to 2.14) | |||
| High (2.9–4.0) | 159 (21%) | 1.23 (0.81 to 1.86) | |||
| Intimate partner violence | 5 (16%) | 1.04 (0.46 to 2.36) | 0.92 | — | — |
| Community factors | |||||
| PrEP disclosure | 300 (21%) | 1.25 (0.92 to 1.71) | 0.16 | 1.07 (0.74 to 1.54) | 0.73 |
| Perceived HIV stigma | |||||
| Low (4–11) | 189 (21%) | 1.41 (0.99 to 2.00) Ref | 0.06 | 1.45 (1.00 to 2.09) Ref | 0.05 |
| High (12–16) | 196 (20%) | ||||
| Structural factors | |||||
| Site: Thika Kisumu |
129 (16%) 256 (23%) |
Ref 1.37 (1.10 to 1.56) |
0.01 |
Ref 1.57 (1.02 to 2.43) |
0.04 |
| Travel ≤1 hour to study | 199 (21%) | 1.41 (1.09 to 1.82) | 0.008 | 1.39 (1.05 to 1.84) | 0.02 |
N refers to the number of participant visits with each factor at which the average adherence was 5+ doses/week; the mean references those participants with 5+ doses/week at 1 or more of the participant visits. All measures were updated over time unless noted as baseline values. Bold indicates significance (P < 0.05) in the multivariable model.
*
Among those with a primary sexual relationship.