ArticleEClinicalMedicine2020
PrEP uptake and adherence in relation to HIV-1 incidence among Kenyan men who have sex with men.
Article in EClinicalMedicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
39 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Demand creation and retention strategies for oral pre-exposure prophylaxis for HIV prevention among men who have sex with men and transgender women: a systematic review and meta-analysis.BMC infectious diseases · 2023Pooled it
- HIV prevalence among men who have sex with men, transgender women and cisgender male sex workers in sub-Saharan Africa: a systematic review and meta-analysis.Journal of the International AIDS Society · 2022Pooled it
- Acceptability, Feasibility, and Safety of the Shauriana Intervention for Young Kenyan Gay, Bisexual, and Other Men who Have Sex with Men, and Exploration of Potential Impact on Sexual Health Outcomes.AIDS and behavior · 2026Trial
- Tenofovir to Prevent HIV Infection in Western China: Pragmatic Randomized Controlled Trial.JMIR public health and surveillance · 2025Trial
- The effect of a social network-based intervention on adherence to HIV preexposure prophylaxis and HIV viral suppression among Kenyan fishermen.AIDS (London, England) · 2025Trial
- HIV Preventive Measures' Adoption Among Men Who Have Sex With Men in West and Central Africa: A Scoping Review On Pre-exposure Prophylaxis and Condom Use.Journal of community health · 2026Review
- A qualitative study on pre-exposure prophylaxis uptake and retention among men who have sex with men and transgender women in Myanmar.International health · 2026Article
- Sustaining the 4 youth by youth HIV prevention intervention in Nigeria: a cluster randomized controlled trial protocol.Implementation science : IS · 2026Article
- Gaps in Effective HIV Pre-exposure Prophylaxis Screening and Uptake Among Fishermen in Kenya.AIDS and behavior · 2026Article
- HIV Pre-Exposure Prophylaxis Service Cascade and Risk Factors Associated with Loss to Follow-Up Among Key Populations in Indonesia: Data from a Real-World Pilot Implementation 2021-2023.AIDS and behavior · 2026Article
- High adherence to oral daily PrEP in a real-world implementation project in Kenya: a brief communication.AIDS research and therapy · 2026Article
- Adherence thresholds of tenofovir diphosphate in dried blood spots for HIV treatment and pre-exposure prophylaxis: A scoping review.Southern African journal of HIV medicine · 2026Review
- Attrition from Care and Barriers to PrEP Use Among Key Populations in Kinshasa, DRC: A Multiple Methods Study.AIDS and behavior · 2025Article
- Risk factors for PrEP and ART medication adherence challenges in cis-gender South African men who have sex with men in Johannesburg and Pretoria.International health · 2025Article
- HIV incidence and adherence after pre-exposure prophylaxis initiation in key populations in Indonesia: Findings from a real-world pilot program 2021-2023.IJID regions · 2025Article
- Interest in Oral Pre-exposure Prophylaxis Among Men Who Have Sex with Men and Transfeminine Persons in HPTN 075, a Multi-center HIV Prevention Study in Sub-Saharan Africa (2015-2017).AIDS and behavior · 2025Article
- Participatory development of theAdvances in global health · 2025Article
- High retention among key populations initiated on HIV pre-exposure prophylaxis in Kigali City, Rwanda.Journal of the International AIDS Society · 2024Article
- Applying the Effective Programme Coverage framework to assess gaps in HIV prevention programmes for female sex workers and men who have sex with men in Nairobi, Kenya: findings from an expanded Polling Booth Survey.Journal of the International AIDS Society · 2024Article
- Identifying patterns of sexual behaviors and PrEP uptake characteristics among MSM who were eligible for PrEP: A national cross-section study.Journal of virus eradication · 2024Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundData on HIV-1 incidence following programmatic pre-exposure prophylaxis (PrEP) uptake by men who have sex with men (MSM) are limited in sub-Saharan Africa.
methodsSince June 2017, MSM participating in an ongoing cohort study in Kenya were offered daily PrEP, assessed for PrEP uptake and adherence, and evaluated for HIV-1 acquisition monthly. We determined tenofovir-diphosphate (TFV-DP) concentrations in dried blood spots 6-12 months after PrEP initiation, and tenofovir (TFV) concentrations and genotypic drug resistance in plasma samples when HIV-1 infection occurred. We assessed HIV-1 incidence by reported PrEP use.
findingsOf 172 MSM, 170 (98·8%) were eligible for PrEP, 140 (82·4%) started it, and 64 (57·7%) reported PrEP use at end of study. Of nine MSM who acquired HIV-1 [incidence rate: 3·9 (95% confidence interval (CI), 2·0-7·4) per 100 person-years (PY)], five reported PrEP use at the time of HIV-1 acquisition [incidence rate: 3·6 (95% CI, 1·5-8·6) per 100 PY)] and four had stopped or had never started PrEP [incidence rate: 4·3 (95% CI, 1·6-11·3) per 100 PY]. Among 76 MSM who reported PrEP use, 11 (14·5%) had protective TFV-DP concentrations of ≥700 fmol/punch (≥4 tablets a week). Among the five MSM who acquired HIV-1 while reporting PrEP use, only one had detectable but low TFV concentrations in plasma and none had genotypic HIV-1 resistance.
interpretationHIV-1 incidence among MSM with access to programmatic PrEP was high and did not differ by reported PrEP use. Only one in seven MSM taking PrEP had protective tenofovir concentrations and four out of five MSM who acquired HIV-1 while reporting PrEP use had not taken it. Strengthened PrEP adherence support is required among MSM in Kenya.
fundingThis work was supported by the International AIDS Vaccine Initiative (IAVI).
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