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

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

doi:10.1007/s10461-022-03576-x

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

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

^*Corresponding author for this work

Medical Social Sciences

Research output: Contribution to journal › Article › peer-review

2 Scopus citations

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.

Original language	English (US)
Pages (from-to)	2376-2386
Number of pages	11
Journal	AIDS and behavior
Volume	26
Issue number	7
DOIs	https://doi.org/10.1007/s10461-022-03576-x
State	Published - Jul 2022

Keywords

Adolescent girls and young women
DREAMS initiative
HIV Pre-Exposure Prophylaxis
PrEP initiation
PrEP persistence

ASJC Scopus subject areas

Social Psychology
Public Health, Environmental and Occupational Health
Infectious Diseases

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s10461-022-03576-x

Cite this

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title = "Pre-Exposure Prophylaxis (PrEP) Initiation and Retention Among Young Kenyan Women",

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.",

keywords = "Adolescent girls and young women, DREAMS initiative, HIV Pre-Exposure Prophylaxis, PrEP initiation, PrEP persistence",

author = "Ohiomoba, {Ramael O.} and Owuor, {Patrick Mbullo} and Wicklife Orero and Irene Were and Franklin Sawo and Ashley Ezema and Maya Jackson-Gibson and Hirschhorn, {Lisa R.}",

note = "Funding Information: 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. Publisher Copyright: {\textcopyright} 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.",

year = "2022",

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doi = "10.1007/s10461-022-03576-x",

language = "English (US)",

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AU - Ohiomoba, Ramael O.

AU - Owuor, Patrick Mbullo

AU - Orero, Wicklife

AU - Were, Irene

AU - Sawo, Franklin

AU - Ezema, Ashley

AU - Jackson-Gibson, Maya

AU - Hirschhorn, Lisa R.

N1 - Funding Information: 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. Publisher Copyright: © 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

PY - 2022/7

Y1 - 2022/7

N2 - 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.

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

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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