Adherence & Retention
Role of adherence in the effectiveness of the CAPRISA microbicide trial
Started by Jessica Haberer, MD, MS on 22 Jul 2010
Last edited by Sarah Arnquist on 24 Sep 2010
The investigators of the CAPRISA trial announced at the International AIDS Conference in Vienna that a microbicide containing 1% tenofovir was found to be 39% effective in reducing a woman’s risk of becoming infected with HIV during sex and 51% effective in preventing genital herpes infections in the women participating in the trial. Effectiveness was greatly influenced by adherence. For example, the risk of acquiring HIV decreased by 54% in women with >80% adherence compared to 28% in women with <50% adherence. Below is a summary of the role adherence played in the trial, and more can be found at:
http://www.caprisa.org/joomla/Micro/CAPRISA%20004%20Adherence%20factsheet_20%...
This study shows the importance of adherence in accurately interpreting the findings in clinical trials. I'd be curious to hear reactions from the Adherence and Retention Community.
Regards,
Jessica Haberer
• The CAPRISA 004 trial had good adherence—on average 72.2 percent of reported sex acts were covered by two doses of tenofovir gel.
• Although adherence is challenging to measure, accurate assessment of adherence is important because it influences the level of protection observed in a study.
• CAPRISA 004 measured adherence based on monthly self-reports and counts of used and unused gel applicators returned by the participants.
• Women who followed the prescribed regimen of two doses of tenofovir gel for more than 80 percent of their sex acts had a 54 percent lower risk of acquiring HIV.
• CAPRISA 004 used innovative methods to support adherence, including motivational interviewing techniques, to increase adherence to gel use.
• Future trials will need to place greater emphasis on enhancing and objectively measuring adherence in light of its substantial influence on the trial outcome.
Keywords: Publications & Research
