Photo Credit: Vonschonertagen

Among young men who have sex with men and transgender women (YMSM/TGW) who are on daily pre-exposure prophylaxis (PrEP), point-of-care urine tenofovir (TFV) rapid assay (UTRA) testing predicted PrEP discontinuation more accurately than self-reported adherence, according to a study led by researchers from the University of California, San Diego. Tyler Martinson, MD, and colleagues found that among 100 study participants, 19% had low urine TFV and 21% discontinued PrEP, while 11% self-reported low PrEP adherence (<4 pills per week). Self-reported low PrEP adherence was only 43% sensitive/84% specific in predicting low TFV levels and was not associated with PrEP discontinuation. Compared to gold-standard liquid chromatography tandem mass spectrometry (LC/MS/MS), UTRA testing was found to have a 98% positive and 100% negative predictive value. The researchers concluded that based on their findings, UTRA testing may be a useful clinical tool identifying those who are more likely to discontinue PrEP and require intervention.