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

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Abstract

The DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored, Safe) Initiative works to reduce HIV infection among adolescent girls and young women (AGYW) through prevention interventions including Pre-Exposure Prophylaxis (PrEP). Pamoja CBO in Kisumu, Kenya implemented DREAMS. We describe PrEP initiation and persistence in 549 AGYW who started PrEP through Pamoja and factors associated with discontinuation. Median persistence time was 308 days (95% CI 245, 382) with 59% of AGYW discontinuing by the end of the study. The most common reasons for stopping PrEP were lack of perceived risk (27.9%) and relocation (18.7%). In the multivariable model, only age < 18 was associated with stopping PrEP. Younger age was associated with shorter time to discontinuation. Implementing PrEP through DREAMS was successful in supporting initiation of PrEP for AGYW. However, low rates of persistence at 1 year emphasizes the need for strategies to support PrEP persistence if HIV elimination is to be achieved.

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Data Availability

The dataset analyzed during the current study are not publicly available to protect the identity of the young women in the program but are available from the corresponding author on reasonable request.

Code Availability

The code is available upon reasonable request.

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Acknowledgements

We would like to acknowledge and thank the Pamoja staff members and DREAMS beneficiaries who participated in or contributed to our study. We would also like to thank the Ministry of Health, Seme Sub-County and village leaders who helped make this study a possibility.

Funding

No funds, grants, or other support was received.

Author information

Authors and Affiliations

  1. Feinberg School of Medicine, Northwestern University, Chicago, USA

    Ramael O. Ohiomoba, Ashley Ezema & Maya Jackson-Gibson

  2. Department of Anthropology, Northwestern University, Evanston, USA

    Patrick Mbullo Owuor

  3. Pamoja CBO, Kisumu, Kenya

    Patrick Mbullo Owuor, Wicklife Orero, Irene Were & Franklin Sawo

  4. Department of Medical Social Science, Feinberg School of Medicine, Northwestern University, Chicago, USA

    Lisa R. Hirschhorn

  5. Institute of Global Health, Northwestern University, Chicago, USA

    Lisa R. Hirschhorn

  6. 175 East Delaware, Apt. 8708, Chicago, IL, 60611, USA

    Ramael O. Ohiomoba

Authors
  1. Ramael O. Ohiomoba
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  2. Patrick Mbullo Owuor
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  3. Wicklife Orero
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  4. Irene Were
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  5. Franklin Sawo
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  6. Ashley Ezema
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  7. Maya Jackson-Gibson
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  8. Lisa R. Hirschhorn
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Contributions

ROO and LRH conceptualized the study and manuscript. ROO conducted the data analysis, interpreted the study results, and was the major contributor in writing the manuscript. LRH and PMO also contributed significantly to the interpretation of the results and writing of the manuscript. FS helped compile and provide access to the data. All authors read, reviewed, and approved the final manuscript.

Corresponding author

Correspondence to Ramael O. Ohiomoba.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical Approval

This study was approved by the Institutional Review Board of Northwestern University (STU00207400) and Ethical and Scientific Review Committee of AMREF (P470-2018) African Medical Research Education Foundation.

Consent to Participate

Informed consent was obtained from all individual participants included in the study.

Consent for Publication

At the time of enrollment, beneficiaries signed a written consent form to participate in a study evaluating the DREAMS program and allowing their information to be shared with study partners. Furthermore, the data used in this project was routine programmatic data and was deidentified.

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Ohiomoba, R.O., Owuor, P.M., Orero, W. et al. Pre-Exposure Prophylaxis (PrEP) Initiation and Retention Among Young Kenyan Women. AIDS Behav 26, 2376–2386 (2022). https://doi.org/10.1007/s10461-022-03576-x

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  • DOI: https://doi.org/10.1007/s10461-022-03576-x

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