ArticlePloS one2021
"I wish to remain HIV negative": Pre-exposure prophylaxis adherence and persistence in transgender women and men who have sex with men in coastal Kenya.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 3 syntheses or guidelines pooled it, 43 citations in OpenAlex.
- Marriage and Steady Relationships with Women in Men Who Have Sex with Men in Sub-Saharan Africa: A Mixed-Method Systematic Review and Meta-analyses.AIDS and behavior · 2025Pooled 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
- Substance Use and Adherence to HIV Pre-Exposure Prophylaxis in Studies Enrolling Men Who Have Sex with Men and Transgender Women: A Systematic Review.AIDS and behavior · 2023Pooled it
- Effect of HIV Self-Testing on PrEP Adherence Among Gender-Diverse Sex Workers in Uganda: A Randomized Trial.Journal of acquired immune deficiency syndromes (1999) · 2022Trial
- Review
- Loss to Follow-Up and Visit Nonadherence in an HIV Incidence Cohort in Kisumu, Kenya.Journal of acquired immune deficiency syndromes (1999) · 2026Article
- Alcohol Use and the Care Continuum for HIV Preexposure Prophylaxis: An Updated Scoping Review of Research and Interventions.AIDS and behavior · 2026Review
- 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
- Stigmatization and Disparities in Healthcare Among LGBTQ Population in Africa: Advancing Health Equity.Public health challenges · 2026Article
- Facilitators and Barriers to Hiv Pre-Exposure Prophylaxis Adherence and Retention Among Young Men Who have Sex With Men: A Meta-Ethnographic Scoping Review.AIDS and behavior · 2025Article
- Article
- Participatory development of theAdvances in global health · 2025Article
- Scoping review of HIV-related intersectional stigma among sexual and gender minorities in sub-Saharan Africa.BMJ open · 2024Article
- Factors associated with retention and adherence on Pre-Exposure Prophylaxis among men who have sex with men in Kigali, Rwanda.PLOS global public health · 2024Article
- Sociodemographic and clinical follow-up profile of transgender people accessing pre-exposure prophylaxis for the risk of HIV transmission in São Paulo, Brazil (2018-2021).Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil · 2024Article
- Trans/Travesti/+: PrEP in specialized services before and during the COVID-19 pandemic.Revista de saude publica · 2024Article
- Healthcare access and barriers to utilization among transgender and gender diverse people in Africa: a systematic review.BMC global and public health · 2024Review
- A Scoping Review of Oral Pre-exposure Prophylaxis for Cisgender and Transgender Adolescent Girls and Young Women: What Works and Where Do We Go from Here?AIDS and behavior · 2023Article
- Understanding the social and structural context of oral PrEP delivery: an ethnography exploring barriers and facilitators impacting transgender women who engage in street-based sex work in Baltimore, Maryland.AIDS research and therapy · 2023Article
- Challenges with PrEP Uptake and Adherence Among Gay, Bisexual, and Other Men Who Have Sex with Men in Kisumu, Kenya.AIDS and behavior · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 5 institutions in 4 countries.
Funding
Abstract
backgroundTransgender women (TGW) and men who have sex with men (MSM) in sub-Saharan Africa have high HIV acquisition risks and can benefit from daily pre-exposure prophylaxis (PrEP). We assessed PrEP adherence by measuring tenofovir-diphosphate (TFV-DP) levels and explore motives for PrEP persistence in TGW and MSM.
methodsParticipants were enrolled in a one-year PrEP programme and made quarterly visits irrespective of whether they were still using PrEP. At their month 6 visit, participants provided a dried blood spot to test for TFV-DP levels; protective levels were defined as those compatible with ≥4 pills per week (700-1249 fmol/punch). Before TFV-DP levels were available, a sub-set of these participants were invited for an in-depth interview (IDI). Semi-structured IDI topic guides were used to explore motives to uptake, adhere to, and discontinue PrEP. IDI data were analyzed thematically.
resultsFifty-three participants (42 MSM and 11 TGW) were enrolled. At month 6, 11 (20.7%) participants (8 MSM and 3 TGW) were lost to follow up or stopped taking PrEP. Any TFV-DP was detected in 62.5% (5/8) of TGW vs. 14.7% of MSM (5/34, p = 0.01). Protective levels were detected in 37.5% of TGW (3/8), but not in any MSM. Nineteen IDI were conducted with 7 TGW and 9 MSM on PrEP, and 1 TGW and 2 MSM off PrEP. Unplanned or frequent risky sexual risk behaviour were the main motives for PrEP uptake. Among participants on PrEP, TGW had a more complete understanding of the benefits of PrEP. Inconsistent PrEP use was attributed to situational factors. Motives to discontinue PrEP included negative reactions from partners and stigmatizing healthcare services.
conclusionWhile MSM evinced greater adherence challenges in this PrEP programme, almost 40% of TGW were protected by PrEP. Given high HIV incidences in TGW these findings hold promise for TGW PrEP programming in the region.
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Registered trials
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