Structural influences on delivery and use of oral HIV PrEP among adolescent girls and young women seeking post abortion care in Kenya.

Journal: EClinicalMedicine

Volume: 68

Issue: 

Year of Publication: 

Affiliated Institutions:  Department of Epidemiology, University of Washington, USA. Department of Global Health, University of Washington, USA. Marie Stopes Kenya, Kenya. Center for Microbiology Research, Kenya Medical Research Institute, Kenya. Center for Clinical Research, Kenya Medical Research Institute, Kenya.

Abstract summary 

Adolescent girls and young women (AGYW) in East and southern Africa experience a disproportionate burden of HIV incidence. Integrating HIV pre-exposure prophylaxis (PrEP) within existing programs is a key component of addressing this disparity.We evaluated an oral PrEP program integrated into post-abortion care (PAC) in Kenya from March 2021 to November 2022. Technical advisors trained staff at PAC clinics on PrEP delivery, abstracted program data from each clinic, and collected data on structural characteristics. Utilizing a modified Poisson regression, we estimated the effect of structural factors on the probability of PrEP offer and uptake.We abstracted data on 6877 AGYW, aged 15-30 years, across 14 PAC clinics. PrEP offers were made to 57.4% of PAC clients and 14.1% initiated PrEP. Offers were associated with an increased probability at clinics that had consistent supply of PrEP (relative risk (RR):1.81, 95% CI: 1.1-2.95), inconsistent HIV testing commodities (RR: 1.89, 95% CI: 1.29-2.78), had all providers trained (RR: 1.65, 95% CI: 1.01, 2.68), and were public (RR: 1.89, 95% CI: 1.29-2.78). These same factors were associated with PrEP uptake: consistent supply of PrEP (RR: 2.71, 95% CI: 1.44-5.09), inconsistent HIV testing commodities (RR: 2.55, 95% CI: 1.39-4.67), all providers trained (RR: 2.61, 95% CI: 1.38-4.92), and were public (RR: 2.55, 95% CI: 1.39-4.67).Greater success with integration of HIV prevention into reproductive health services will likely require investments in systems, such as human resources and PrEP and HIV testing commodities, to create stable availability and ensure consistent access.PrEDIRA 2 was supported by funding from Children's Investment Fund Foundation (R-2001-04433). Ms. Zia was funded by the NIH Ruth L. Kirchstein pre-doctoral award (5F31HD105494-02) and Dr. Heffron was funded by National Institute of Mental Health (K24MH123371).

Authors & Co-authors:  Heffron Bukusi Mugo Wanyama Ngure Thomas Mokoyo Kimani June Njiru Mwangi Mogaka Nyamwaro Nyerere Etyang Zia

Study Outcome 

Source Link: Visit source

Statistics
Citations :  UNAIDS . 2022. Danger: UNAIDS global AIDS update 2022.https://www.unaids.org/en/resources/documents/2022/in-danger-global-aids-update Available from:
Authors :  16
Identifiers
Doi : 102416
SSN : 2589-5370
Study Population
Women,Girls
Mesh Terms
Other Terms
Abortion;Adolescent girls and young women;HIV prevention;Health systems;Structural factors
Study Design
Study Approach
Country of Study
Kenya
Publication Country
England