{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T14:05:58Z","timestamp":1740146758148,"version":"3.37.3"},"reference-count":36,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2021,5,27]],"date-time":"2021-05-27T00:00:00Z","timestamp":1622073600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000200","name":"United States Agency for International Development","doi-asserted-by":"publisher","award":["AID-OAA-A-14-00011"],"award-info":[{"award-number":["AID-OAA-A-14-00011"]}],"id":[{"id":"10.13039\/100000200","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009054","name":"U.S. President\u2019s Emergency Plan for AIDS Relief","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100009054","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Oral, vaginal and other pre-exposure prophylaxis (PrEP) products for HIV prevention are in various stages of development. Low adherence poses a serious challenge to successful evaluation in trials. In a previous study, we developed tools to screen for general adherence and specifically monitor intravaginal ring adherence within the context of HIV prevention clinical trials. This study aimed to further validate the screening tool and to adapt and provide initial psychometric validation for an oral pill monitoring tool.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Materials and methods<\/jats:title>\n<jats:p>We administered a cross-sectional survey between June and October 2018 at a trial site located near Cape Town, South Africa, and another in Thika, Kenya, with 193 women who had experience using daily oral pills. We fit confirmatory factor analysis models on the screening tool items to assess our previously-hypothesized subscale structure. We conducted an exploratory factor analysis of oral PrEP monitoring items to determine the underlying subscale structure. We then assessed the construct validity of each tool by comparing subscales against each other within the current sample and against our original sample, from a study conducted in four sites in South Africa, including Cape Town.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The screening tool structure showed moderate evidence of construct validity. As a whole, the tool performed in a similar way to the original sample. The monitoring tool items, which were revised to assess perceptions about and experiences using daily oral PrEP, factored into five subscales that showed moderate to good reliability. Four of the five subscales had a similar structure overall to the vaginal ring monitoring tool from which they were adapted.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Accurate measurement of HIV-prevention product adherence is of critical importance to the assessment of product efficacy and safety in clinical trials, and the support of safe and effective product use in non-trial settings. In this study, we provide further validation for these measures, demonstrating the screening tool\u2019s utility in additional populations and adapting the monitoring tool\u2019s utility for different HIV-prevention products.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0251823","type":"journal-article","created":{"date-parts":[[2021,5,27]],"date-time":"2021-05-27T19:15:27Z","timestamp":1622142927000},"page":"e0251823","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Adaptation and validation of simple tools to screen and monitor for oral PrEP adherence"],"prefix":"10.1371","volume":"16","author":[{"given":"Seth","family":"Zissette","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9823-3675","authenticated-orcid":true,"given":"Elizabeth E.","family":"Tolley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andres","family":"Martinez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Homaira","family":"Hanif","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"Gill","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nelly","family":"Mugo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Myers","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ednar","family":"Casmir","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Menna","family":"Duyver","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth","family":"Ngure","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gustavo F.","family":"Doncel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,5,27]]},"reference":[{"issue":"5","key":"pone.0251823.ref001","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1056\/NEJMoa1108524","article-title":"Antiretroviral prophylaxis for HIV prevention in heterosexual men and women","volume":"367","author":"JM Baeten","year":"2012","journal-title":"New England Journal of Medicine"},{"issue":"9883","key":"pone.0251823.ref002","doi-asserted-by":"crossref","first-page":"2083","DOI":"10.1016\/S0140-6736(13)61127-7","article-title":"Antiretroviral prophylaxis for HIV infection in injecting drug users in Bangkok, Thailand (the Bangkok Tenofovir Study): a randomised, double-blind, placebo-controlled phase 3 trial","volume":"381","author":"K Choopanya","year":"2013","journal-title":"The Lancet"},{"issue":"5","key":"pone.0251823.ref003","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1056\/NEJMoa1110711","article-title":"Antiretroviral preexposure prophylaxis for heterosexual HIV transmission","volume":"367","author":"MC Thigpen","year":"2012","journal-title":"Botswana. New England Journal of Medicine"},{"issue":"5","key":"pone.0251823.ref004","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1097\/COH.0000000000000567","article-title":"Comprehensive HIV risk reduction interventions for 2020 and beyond: product choices and effective service-delivery platforms for individual needs and population-level impact","volume":"14","author":"J Velloza","year":"2019","journal-title":"Current Opinion in HIV and AIDS"},{"issue":"1","key":"pone.0251823.ref005","doi-asserted-by":"crossref","DOI":"10.1515\/scid-2019-0011","article-title":"Advancing Novel PrEP Products\u2013Alternatives to Non-Inferiority","volume":"11","author":"DV Glidden","year":"2019","journal-title":"Statistical communications in infectious diseases"},{"issue":"5","key":"pone.0251823.ref006","doi-asserted-by":"crossref","first-page":"e25283","DOI":"10.1002\/jia2.25283","article-title":"End\u2010user preference for and choice of four vaginally delivered HIV prevention methods among young 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