What question did this study set out to answer?

To assess the adherence levels to oral PrEP using biomarkers in a real-world setting in Kenya.

March 26, 2026Open Access

High adherence to oral daily PrEP in a real-world implementation project in Kenya: a brief communication

Puntos clave

To assess the adherence levels to oral PrEP using biomarkers in a real-world setting in Kenya.
Tested dried blood spots (DBS) from PrEP clients at public HIV clinics
Extracted DBS using a methanol-water method
Quantified drug concentrations using liquid chromatography-tandem mass spectrometry
96% of samples had detectable levels of tenofovir diphosphate (TFV-DP)
71% demonstrated optimal adherence of ≥ 4 doses/week
Higher adherence was noted among older clients and men

Resumen

Abstract Objective biomarkers of oral pre-exposure prophylaxis (PrEP), such as tenofovir diphosphate (TFV-DP) in dried blood spots (DBS), remain critical for interpreting PrEP adherence. We tested 195 DBS randomly collected from 168 of 4,955 PrEP clients returning for refills at 25 public HIV clinics in Kenya. DBS were extracted using the 50:50 methanol: water method, and drug concentrations quantified using liquid chromatography-tandem mass spectrometry. Optimal adherence was defined as ≥ 900 fmol/punch, corresponding to ≥ 4 doses/week. TFV-DP was detectable in 96% (188/195) of samples; 71% (138/195) had optimal adherence, higher among older clients and men. Optimal adherence is achievable in real-world PrEP programs.

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