Adoption of HIV pre-exposure prophylaxis among women at high risk of HIV infection in Kenya

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  • Bien-Gund, C.H.
    • Other Affiliation: University of Pennsylvania
  • Ochwal, P.
    • Other Affiliation: Impact Research and Development Organisation
  • Marcus, N.
    • Other Affiliation: University of Pennsylvania
  • Bair, E.F.
    • Other Affiliation: University of Pennsylvania
  • Napierala, S.
    • Other Affiliation: RTI International
  • Maman, S.
    • Affiliation: Gillings School of Global Public Health, Department of Health Behavior
  • Agot, K.
    • Other Affiliation: Impact Research and Development Organisation
  • Thirumurthy, H.
    • Other Affiliation: University of Pennsylvania
Abstract
  • In 2017, Kenya became one of the first African countries to provide pre-exposure prophylaxis (PrEP) in its national HIV prevention plan. We sought to characterize factors associated with PrEP uptake and persistence among a cohort of women at risk of HIV infection during the early stages of PrEP scale-up in Kenya. HIV-negative women ≥18 years with ≥2 sexual partners in the past 4 weeks were recruited as part of an ongoing cluster randomized trial of an HIV self-testing intervention. PrEP use was assessed at baseline and at 6- and 12-month follow-up visits. Between June 2017 and August 2018, 2,086 were enrolled and had complete baseline data. 138 (6.6%) reported PrEP use during the first year of the study. Although PrEP use increased, persistence on PrEP was low, and less than half of individuals reported continuing PrEP at follow-up visits. In multivariate analyses, PrEP use was associated with recent STIs, having an HIV-positive primary partner, having regular transactional sex in the past 12 months, and being a female sex worker. In the early stages of PrEP scale-up in Kenya, uptake increased modestly among women with risk factors for HIV infection, but overall uptake and persistence was low.
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  • Article
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  • In Copyright
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  • Attribution 4.0 International
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  • PLoS ONE
Journal volume
  • 17
Journal issue
  • 9 9
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  • English
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