Evidence map›Paper›PMID 35822945›Full record

ArticleJournal of the International AIDS Society2022

PrEP use and HIV seroconversion rates in adolescent girls and young women from Kenya and South Africa: the POWER demonstration project.

Connie L Celum, Elizabeth A Bukusi, Linda Gail Bekker, Sinead Delany-Moretlwe, Lara Kidoguchi, Victor Omollo, Elzette Rousseau, Danielle Travill, Jennifer F Morton, Felix Mogaka and 14 more

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the International AIDS Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06446752 (A Phase 3 Randomized, Observer-Blind, Placebo-Controlled Study to Assess Efficacy of Meningococcal Group B), which is not on this map. Cited by 70 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
70citing papers in PubMed, 2 pooled it
8.4field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT06446752 phase3active not recruitingnot on this mapstarted 2024, after this paper: background citation

A Phase 3 Randomized, Observer-Blind, Placebo-Controlled Study to Assess Efficacy of Meningococcal Group B (rMenB+OMV NZ (Bexsero)) in Preventing Gonococcal Infection Among South African Cis-Gender Women

TypeinterventionalSponsorUniversity of WashingtonRan2024 to 2027Enrolled1,100ConditionsGonorrhea, Gonorrhea of Pharynx, Gonorrhea of Anus, Gonorrhea of CervixArmsBexsero, Placebo
3 · Its place in the literature

Who cites it

70 citing papers in PubMed, 2 syntheses or guidelines pooled it, 92 citations in OpenAlex.

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10 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors at 8 institutions in 3 countries.

Connie L CelumDepartment of Global Health, University of Washington, Seattle, Washington, USA.
Elizabeth A BukusiDepartment of Global Health, University of Washington, Seattle, Washington, USA.
Linda Gail BekkerDesmond Tutu HIV Centre, Cape Town, South Africa.ORCID https://orcid.org/0000-0002-0755-4386
Sinead Delany-MoretlweWits RHI, University of the Witwatersrand, Johannesburg, South Africa.
Lara KidoguchiDepartment of Global Health, University of Washington, Seattle, Washington, USA.
Victor OmolloCenter for Microbiology Research, Kenya Medical Research Institute, Kisumu, Kenya.
Elzette RousseauDesmond Tutu HIV Centre, Cape Town, South Africa.ORCID https://orcid.org/0000-0002-6487-6736
Danielle TravillWits RHI, University of the Witwatersrand, Johannesburg, South Africa.
Jennifer F MortonDepartment of Global Health, University of Washington, Seattle, Washington, USA.
Felix MogakaCenter for Microbiology Research, Kenya Medical Research Institute, Kisumu, Kenya.
Gabrielle O'MalleyDepartment of Global Health, University of Washington, Seattle, Washington, USA.
Gena BarnabeeDepartment of Global Health, University of Washington, Seattle, Washington, USA.
Ariane van der StratenCenter for AIDS Prevention Studies, Department of Medicine, University of California San Francisco, San Francisco, California, USA.ORCID https://orcid.org/0000-0001-8536-648X
Deborah DonnellDepartment of Global Health, University of Washington, Seattle, Washington, USA.
Urvi M ParikhUniversity of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Lauren KudrickUniversity of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Peter L AndersonUniversity of Colorado-Anschutz Medical Campus, Aurora, Colorado, USA.
Jessica E HabererCenter for Global Health, Massachusetts General Hospital, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0001-5845-3190
Linxuan WuDepartment of Epidemiology, University of Washington, Seattle, Washington, USA.
Renee HeffronDepartment of Global Health, University of Washington, Seattle, Washington, USA.ORCID https://orcid.org/0000-0001-6039-0352
Rachel JohnsonDepartment of Global Health, University of Washington, Seattle, Washington, USA.
Susan MorrisonDepartment of Global Health, University of Washington, Seattle, Washington, USA.
Jared M BaetenDepartment of Global Health, University of Washington, Seattle, Washington, USA.ORCID https://orcid.org/0000-0001-8242-8438
POWER Study Team
University of Washington · USDesmond Tutu HIV Foundation · ZAKenya Medical Research Institute · KEUniversity of Pittsburgh · USUniversity of the Witwatersrand · ZAHarvard University · USUniversity of California, San Francisco · USUniversity of Colorado Anschutz Medical Campus · US

Funding

Ujima Mentoring ProgramP30MH062246 · NIMH · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI MALLORY O JOHNSON · 2001 to 2026
$57.4M
NIMH NIH HHS P30 MH062246
6 · The paper itself

Abstract

introductionHIV incidence remains high among African adolescent girls and young women (AGYW). The primary objective of this study is to assess pre-exposure prophylaxis (PrEP) initiation, use, persistence and HIV acquisition among African AGYW offered PrEP in order to inform PrEP scale-up.

methodsPOWER was a prospective implementation science evaluation of PrEP delivery for sexually active HIV-negative AGYW ages 16-25 in family planning clinics in Kisumu, Kenya and youth and primary healthcare clinics in Cape Town and Johannesburg, South Africa. Follow-up visits occurred at month 1 and quarterly for up to 36 months. PrEP users were defined based on the month 1 refill. PrEP persistence through month 6 was assessed using Kaplan-Meier survival analysis among AGYW with a month 1 visit, defining non-persistence as an ≥15 day gap in PrEP availability for daily dosing. PrEP execution was evaluated in a subset with PrEP supply from the prior visit sufficient for daily dosing by measuring blood tenofovir diphosphate (TFV-DP) levels.

resultsFrom June 2017 to September 2020, 2550 AGYW were enrolled (1000 in Kisumu, 787 in Cape Town and 763 in Johannesburg). Median age was 21 years, 66% had a sexual partner of unknown HIV status, and 29% had chlamydia and 10% gonorrhoea. Overall, 2397 (94%) initiated PrEP and 749 (31%) had a refill at 1 month. Of AGYW who could reach 6 months of post-PrEP initiation follow-up, 128/646 (20%) persisted with PrEP for 6 months and an additional 92/646 (14%) had a gap and restarted PrEP. TFV-DP levels indicated that 47% (91/193) took an average of ≥4 doses/week. Sixteen HIV seroconversions were observed (incidence 2.2 per 100 person-years, 95% CI 1.2, 3.5); 13 (81%) seroconverters either did not have PrEP dispensed in the study interval prior to seroconversion or TFV-DP levels indicated <4 doses/week in the prior 6 weeks.

conclusionsIn this study of PrEP integration with primary care and reproductive health services for African AGYW, demand for PrEP was high. Although PrEP use decreased in the first months, an important fraction used PrEP through 6 months.  Strategies are needed to simplify PrEP delivery, support adherence and offer long-acting PrEP options to improve persistence and HIV protection.

Indexed as

Anti-HIV AgentsHIV InfectionsHIV SeropositivityPre-Exposure ProphylaxisAdolescentAdultFemaleHumansKenyaMedication AdherenceProspective StudiesSeroconversionSouth AfricaYoung AdultAnti-HIV AgentsadherenceAfricaHIVpersistencepre-exposure prophylaxisyoung women

Identifiers

PMID35822945
PMCPMC9278271
OpenAlexW4285097758

What OpenQuestion holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.