Pre-Exposure Prophylaxis (PrEP) Initiation and Retention Among Young Kenyan Women

Ohiomoba, Ramael; Owuor, Patrick Mbullo; Orero, Wicklife; Were, Irene; Sawo, Franklin; Ezema, Ashley; Jackson-Gibson, Maya; Hirschhorn, Lisa R.

doi:10.1007/s10461-022-03576-x

AIDS Behav

2022

DOI: 10.1007/s10461-022-03576-x

|View full text |Cite

Pre-Exposure Prophylaxis (PrEP) Initiation and Retention Among Young Kenyan Women

Ramael Ohiomoba

Patrick Mbullo Owuor

Wicklife Orero³

et al.

Help me understand this report

Search citation statements

Order By: Relevance

Paper Sections

Select...

Citation Types

Supporting

Mentioning

Contrasting

Year Published

2023

2024

Publication Types

Select...

Article5

Relationship

Self Cite0

Independent5

Authors

Journals

Cited by 9 publications

(1 citation statement)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is therefore critical to understand the drivers and correlates of PrEP non-use so we may find ways to better inform efforts to trigger PrEP re-start when it is indicated. With this information, healthcare providers can support end-users to re-start PrEP when there are strong reasons to use PrEP and the protective impact of PrEP can be maximized to ultimately reduce HIV incidence in this young population.Recent literature provides insight into reasons for oral PrEP discontinuation and non-use, including low selfperceived HIV vulnerability or risk of HIV acquisition, side effects related with PrEP use, pill burden/fatigue, disapproval from family and sexual partners, lack of sexual activity, stigma associated with using PrEP, fear of intimate partner violence (IPV), misinformation about drug resistance related to long term oral PrEP use, accidental disclosure, and limited/loss of access[27,[41][42][43][44][45] (Table2).…”

mentioning

confidence: 99%

Awareness of Heightened Sexual and Behavioral Vulnerability as a Trigger for PrEP Resumption Among Adolescent Girls and Young Women in East and Southern Africa

Reddy,

Palanee-Phillips,

Heffron

2023

Curr HIV/AIDS Rep

View full text Add to dashboard Cite

Purpose of Review East and Southern Africa are the epicenter of the HIV epidemic. High HIV incidence rates among adolescent girls and young women (AGYW) remain stable over the last decade despite access to daily oral PrEP. Some settings have experienced high PrEP uptake among AGYW; however, discontinuation has been high. This review sought to understand drivers of PrEP discontinuation in this population in order to identify potential mechanisms to facilitate PrEP restart and optimize PrEP use. Recent Findings Drivers of PrEP discontinuation included low perceived HIV acquisition risk, PrEP-associated side effects, pill burden, family/sexual partner disapproval, lack of/intermittent sexual activity, PrEP use stigma, fear of intimate partner violence, misinformation about long-term PrEP use, and limited/inconsistent access to PrEP. Summary The most frequently reported driver of PrEP discontinuation was low perceived HIV acquisition risk. This indicates that innovative interventions to help AGYW recognize their HIV risk and make informed decisions about PrEP use are urgently needed.

show abstract

mentioning

confidence: 99%

Awareness of Heightened Sexual and Behavioral Vulnerability as a Trigger for PrEP Resumption Among Adolescent Girls and Young Women in East and Southern Africa

Reddy,

Palanee-Phillips,

Heffron

2023

Curr HIV/AIDS Rep

View full text Add to dashboard Cite

show abstract

Phase 1 randomized pharmacokinetic and safety study of a 90‐day tenofovir vaginal ring in the United States

Liu,

Gundacker,

Richardson

et al. 2024

J Int AIDS Soc.

View full text Add to dashboard Cite

IntroductionTenofovir‐based oral pre‐exposure prophylaxis is currently approved for HIV prevention; however, adherence in women has been low. A vaginal gel containing tenofovir (TFV) demonstrated partial protection to HIV but protection was not confirmed in additional studies. Vaginal rings offer user‐controlled long‐acting HIV prevention that could overcome adherence and protection challenges. TFV may also help prevent herpes simplex virus type 2 acquisition when delivered intravaginally. We evaluated the pharmacokinetics, safety, adherence and acceptability of a 90‐day TFV ring.MethodsBetween January and June 2019, Microbicide Trials Network (MTN)‐038 enrolled 49 HIV‐negative participants into a phase 1, randomized (2:1) trial comparing a 90‐day ring containing 1.4 grams (g) TFV to a placebo ring. TFV concentrations were quantified in plasma, cervicovaginal fluid (CVF), rectal fluid and cervical tissue, and TFV‐diphosphate (TFV‐DP) in cervical tissue. Used rings were analysed for residual TFV. Safety was assessed by adverse events (AEs); acceptability and adherence by self‐report.ResultsMean age was 29.5; 46 identified as cisgender‐female and three gender non‐conforming. There were no differences in the proportion of participants with grade ≥2 genitourinary AEs in the TFV versus placebo arms (p = 0.41); no grade ≥3 AEs were reported. Geometric mean TFV concentrations increased through day 34 in CVF/rectal fluid and day 59 in plasma, but declined across compartments by day 91. Geometric mean TFV‐DP tissue concentrations exceeded the 1000 fmol/mg target through day 56, but fell to 456 fmol/mg at day 91. Among 32 rings returned at the end of the study, 13 had no or low (<0.1 g) residual TFV. Residual TFV did not differ by socio‐demographics, sexual activity, Nugent Score or vaginal microbiota. Most participants reported being fully adherent to ring use: 85% and 81% in the TFV and placebo arms, respectively (p = 1.00). A majority of participants reported liking the ring (median 8 on a 10‐point Likert scale) and reported a high likelihood of using the ring in the future, if effective (median 9).ConclusionsThe 90‐day TFV ring was well‐tolerated, acceptable and exceeded target cervical tissue concentrations through day 56, but declined thereafter. Additional studies are needed to characterize the higher release from TFV rings in some participants and the optimal duration of use.

show abstract

Pre‐exposure prophylaxis implementation gaps among people vulnerable to HIV acquisition: a cross‐sectional analysis in two communities in western Kenya, 2021–2023

Romo,

Schluck,

Kosgei

et al. 2024

J Int AIDS Soc.

View full text Add to dashboard Cite

IntroductionDespite the increasing availability of prevention tools like pre‐exposure prophylaxis (PrEP), HIV incidence remains disproportionately high in sub‐Saharan Africa. We examined PrEP awareness, uptake and persistence among participants enrolling into an HIV incidence cohort in Kenya.MethodsWe used cross‐sectional enrolment data from the Multinational Observational Cohort of HIV and other Infections (MOCHI) in Homa Bay and Kericho, Kenya. The cohort recruited individuals aged 14–55 years with a recent history of sexually transmitted infection, transactional sex, condomless sex and/or injection drug use. Participants completed questionnaires on PrEP, demographics and sexual behaviours. We used multivariable robust Poisson regression to estimate adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) for associations with never hearing of PrEP, never taking PrEP and ever stopping PrEP.ResultsBetween 12/2021 and 5/2023, 399 participants attempted the PrEP questionnaire, of whom 316 (79.2%) were female and median age was 22 years (interquartile range 19–24); 316 of 390 participants (81.0%) engaged in sex work or transactional sex. Of 396 participants who responded to the question, 120 (30.3%) had never heard of PrEP. Of 275 participants who had heard of PrEP, 206 (74.9%) had never taken it. Of 69 participants who had ever taken PrEP, 50 (72.5%) stopped it at some time prior to enrolment. Participants aged 15–19 years more often reported never taking PrEP compared with those 25–36 years (aPR 1.31, 95% CI: 1.06–1.61). Participants who knew someone who took PrEP less often reported never hearing about PrEP (aPR 0.10, 95% CI: 0.04–0.23) and never taking PrEP (aPR: 0.69, 95% CI: 0.60–0.80). Stopping PrEP was more common among participants with a weekly household income ≤1000 versus >1000 Kenyan shillings (aPR 1.40, 95% CI: 1.02–1.93) and those using alcohol/drugs before sex (aPR 1.53, 95% CI: 1.03–2.26). Stopping PrEP was less common among those engaging in sex work or transactional sex (aPR 0.6, 95% CI: 0.40–0.92).ConclusionsWe identified substantial gaps in PrEP awareness, uptake and persistence, which were associated with potential system‐ and individual‐level risk factors. Our analyses also highlight the importance of increasing PrEP engagement among individuals who do not know others taking PrEP.

show abstract

scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.

Contact Info

customersupport@researchsolutions.com

10624 S. Eastern Ave., Ste. A-614

Henderson, NV 89052, USA

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Blog Terms and Conditions API Terms Privacy Policy Contact Cookie Preferences Do Not Sell or Share My Personal Information

Made with 💙 for researchers

Part of the Research Solutions Family.

Pre-Exposure Prophylaxis (PrEP) Initiation and Retention Among Young Kenyan Women

Cited by 9 publications

References 18 publications

Awareness of Heightened Sexual and Behavioral Vulnerability as a Trigger for PrEP Resumption Among Adolescent Girls and Young Women in East and Southern Africa

Awareness of Heightened Sexual and Behavioral Vulnerability as a Trigger for PrEP Resumption Among Adolescent Girls and Young Women in East and Southern Africa

Phase 1 randomized pharmacokinetic and safety study of a 90‐day tenofovir vaginal ring in the United States

Pre‐exposure prophylaxis implementation gaps among people vulnerable to HIV acquisition: a cross‐sectional analysis in two communities in western Kenya, 2021–2023

Contact Info

Product

Resources

About