{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T10:45:38Z","timestamp":1759229138769,"version":"3.41.2"},"reference-count":49,"publisher":"Wiley","issue":"S3","license":[{"start":{"date-parts":[[2024,7,19]],"date-time":"2024-07-19T00:00:00Z","timestamp":1721347200000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P30AI050410"],"award-info":[{"award-number":["P30AI050410"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Daily oral HIV pre\u2010exposure prophylaxis (PrEP) with tenofovir\/emtricitabine (TDF\/FTC) is recommended for people who inject drugs (PWID) but coverage is low. The real\u2010life effectiveness of PrEP among PWID is unknown as previous studies were conducted in controlled settings and mainly relied on self\u2010report. Analysis of PrEP metabolites\u2014tenofovir diphosphate (TFVdp) and emtricitabine triphosphate (FTCtp)\u2014offers an objective measure of adherence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>To analyse longitudinal patterns of PrEP adherence among PWID in Ukraine, we used data from a community\u2010based implementation trial conducted in Kyiv between July 2020 and March 2021 to test the efficacy of SMS reminders to improve adherence. Among 199 enrolled participants, 156 (78.4%) were retained through 6 months. Based on TFVdp\/FTCtp levels assessed at 3 and 6 months, we identified groups with various adherence patterns (adherent at \u22652 doses\/week, improved, worsened, non\u2010adherent). Correlates of adherence were analysed using multinomial logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Most participants (53.8%, <jats:italic>n<\/jats:italic> = 84\/156) had no detectable metabolites at both assessments; 7.1% (<jats:italic>n<\/jats:italic> = 11\/156) were consistently taking \u22652 doses\/week; 1.3% (<jats:italic>n<\/jats:italic> = 2\/156) were consistently taking \u22654 doses\/week; 13.5% (<jats:italic>n<\/jats:italic> = 21\/156) exhibited improved and 21.8% (<jats:italic>n<\/jats:italic> = 34\/156) had worsened adherence at 6 compared to 3 months. \u201cWhite coat compliance\u201d (increased dosing prior to assessment) was common. Consistent adherence was associated with SMS reminders, younger age, employment, lower income, longer injection drug use duration, recent high\u2010risk injecting (receptive syringe sharing, using pre\u2010filled syringe, back\u2010 or front\u2010loading, container sharing), absence of overdose in the past 6 months, perceived HIV risk through sexual intercourse and higher PrEP self\u2010efficacy. Alcohol consumption was associated with inconsistent PrEP use. Groups with improved and worsened adherence did not differ.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Daily oral PrEP may not achieve the desired effectiveness among PWID as a standalone intervention, calling for testing of alternative PrEP formulations and innovative integrated risk reduction strategies, especially in the context of HIV epidemics associated with injection drug use in eastern Europe and central Asia and the public health crisis in Ukraine caused by the war with Russia. SMS reminders may be effective among PWID who prioritize PrEP. Our findings offer practical guidance in identifying PWID who are likely to benefit from PrEP and those who need additional support.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.26319","type":"journal-article","created":{"date-parts":[[2024,7,19]],"date-time":"2024-07-19T08:16:09Z","timestamp":1721376969000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Patterns of daily oral HIV PrEP adherence among people who inject drugs in Ukraine: an analysis of biomarkers"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7606-8413","authenticated-orcid":false,"given":"Olga","family":"Morozova","sequence":"first","affiliation":[{"name":"Biological Sciences Division Department of Public Health Sciences University of Chicago  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marina","family":"Kornilova","sequence":"additional","affiliation":[{"name":"International Charitable Foundation \u201cAlliance for Public Health\u201d  Kyiv Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olena","family":"Makarenko","sequence":"additional","affiliation":[{"name":"Ukrainian Institute on Public Health Policy  Kyiv Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Svitlana","family":"Antoniak","sequence":"additional","affiliation":[{"name":"Gromashevsky Institute of Epidemiology and Infectious Diseases National Academy of Medical Sciences of Ukraine  Kyiv Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariia","family":"Liulchuk","sequence":"additional","affiliation":[{"name":"Gromashevsky Institute of Epidemiology and Infectious Diseases National Academy of Medical Sciences of Ukraine  Kyiv Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olga","family":"Varetska","sequence":"additional","affiliation":[{"name":"International Charitable Foundation \u201cAlliance for Public Health\u201d  Kyiv Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2862-4977","authenticated-orcid":false,"given":"Kostyantyn","family":"Dumchev","sequence":"additional","affiliation":[{"name":"Ukrainian Institute on Public Health Policy  Kyiv Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,7,19]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-048478"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61127-7"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-020-02988-x"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11904-021-00556-z"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.951682"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(16)30208-9"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(21)00127-2"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12954-023-00729-6"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(14)70847-3"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000000613"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11904-020-00502-5"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1089\/aid.2012.0089"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01017-16"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01710-17"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpt.2845"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000002558"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofab658"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2023.104284"},{"key":"e_1_2_11_20_1","unstructured":"UNAIDS.In Danger: UNAIDS Global AIDS Update 2022 (Full Report) [Internet].2022[cited 2023 Aug 24].https:\/\/www.unaids.org\/en\/resources\/documents\/2022\/in\u2010danger\u2010global\u2010aids\u2010update"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-020-09373-2"},{"key":"e_1_2_11_22_1","unstructured":"SazonovaY DuchenkoH KovtunO KuzinI.Estimation of the population size of key populations in Ukraine (published in Ukrainian) [Internet]. 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