2024 · Journal of the International AIDS Society · open access
Urine tenofovir testing for real-time PrEP adherence feedback: a qualitative study involving transgender women in Uganda
Mujugira et al.
The finding, in our words
Transgender women in Uganda initially anxious about point-of-care urine tenofovir testing for PrEP adherence monitoring found it acceptable after counselling, though test interpretation caused confusion as two lines indicated non-adherence rather than positivity as with HIV self-tests. Some participants avoided clinic visits to prevent detection of non-adherence, a behaviour termed 'white coat dosing', highlighting the need for tailored adherence strategies in this population.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
Transgender women in Uganda valued integrated PrEP and STI services that used urine self-collection for therapeutic drug monitoring and infection detection. The convenience of this approach motivated adherence to pre-exposure prophylaxis, while same-day initiation and drug-level feedback supported engagement with care, demonstrating that decentralised, patient-centric models can improve prevention uptake in vulnerable populations.
A study of 2500 women found 99.0% agreement between first-void urine and vaginal self-sampling for HPV detection using Cobas4800, with 98.1% of participants preferring urine. Although conducted in a resource-limited setting which may limit generalisability, these results support urine as a viable sample type for decentralised, patient-centric screening.
First-void urine and self-collected vaginal swabs showed similar sensitivity and specificity to clinician-collected cervical samples for high-risk HPV detection across two real-time PCR assays, supporting their use as decentralised, patient-collected alternatives; most women preferred first-void urine for regular cervical screening.
This randomised sub-study found return rates of 10.4% for Colli-Pee, 10.1% for FLOQSwabs and 7.4% for Evalyn-Brush. All devices yielded sufficient DNA with low invalid rates, but the authors noted the study was limited by low overall participation.
At-home volumetric absorptive microsampling (VAMS) for anti-seizure medicines was feasible and reliable, with strong correlations to clinic VAMS and low bias for lacosamide, lamotrigine and levetiracetam; quantitative dried blood spot (qDBS) was a reliable alternative in the ambulatory setting, though older age reduced sampling quality.