Evidence map›Paper›PMID 38451448›Full record

ArticleAIDS and behavior2024

The Effect of Stigma on Family Planning and HIV Pre-exposure Prophylaxis Decisions of Young Women Accessing Post-Abortion Care in Kenya.

Yasaman Zia, Lydia Etyang, Margaret Mwangi, Roy Njiru, Felix Mogaka, Lavender June, Irene Njeru, Job Makoyo, Susan Kimani, Kenneth Ngure and 7 more

Open access · hybridAbstract read
In one paragraph

Article in AIDS and behavior, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.2field-weighted citation impact, top 24% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
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

17 authors at 5 institutions in 2 countries.

Yasaman ZiaDepartment of Epidemiology, University of Washington, Seattle, WA, USA.
Lydia EtyangPartners in Health and Research Development, Kenya Medical Research Institute, Nairobi, Kenya.
Margaret MwangiPartners in Health and Research Development, Kenya Medical Research Institute, Nairobi, Kenya.
Roy NjiruPartners in Health and Research Development, Kenya Medical Research Institute, Nairobi, Kenya.
Felix MogakaResearch Care and Training Program, Kenya Medical Research Institute, Thika, Kenya.
Lavender JuneResearch Care and Training Program, Kenya Medical Research Institute, Thika, Kenya.
Irene NjeruPartners in Health and Research Development, Kenya Medical Research Institute, Nairobi, Kenya.
Job MakoyoMarie Stopes Kenya, Nairobi, Kenya.
Susan KimaniMarie Stopes Kenya, Nairobi, Kenya.
Kenneth NgureDepartment of Global Health, University of Washington, Seattle, WA, USA.
Inviolata WanyamaMarie Stopes Kenya, Nairobi, Kenya.
Elizabeth BukusiDepartment of Global Health, University of Washington, Seattle, WA, USA.
Bernard NyerereResearch Care and Training Program, Kenya Medical Research Institute, Thika, Kenya.
Cyprian NyamwaroMarie Stopes Kenya, Nairobi, Kenya.
Nelly MugoDepartment of Global Health, University of Washington, Seattle, WA, USA.
Renee HeffronDepartment of Epidemiology, University of Washington, Seattle, WA, USA. rheffron@uabmc.edu.
PrEDIRA team
Kenya Medical Research Institute · KEKenya Forest Service · KEUniversity of Washington · USJomo Kenyatta University of Agriculture and Technology · KEPartners for Health and Development in Africa · KE

Funding

Mentoring and research to prepare oral PrEP delivery platforms for novel HIVprevention productsK24MH123371 · NIMH · UNIVERSITY OF WASHINGTON · PI HEFFRON, RENEE A. · 2021 to 2025
$749k
Optimizing Pre-exposure Prophylaxis Use among Adolescent Girls and Young Women Seeking Reproductive Health Care in KenyaF31HD105494 · NICHD · UNIVERSITY OF WASHINGTON · PI ZIA, YASAMAN · 2021 to 2022
$86k
Children's Investment Fund Foundation R-2001-04433National Institute of Child Health and Human Development 5F31HD105494-02NICHD NIH HHS F31 HD105494NIMH NIH HHS K24 MH123371NIMH NIH HHS K24MH123371
6 · The paper itself

Abstract

Adolescent girls and young women (AGYW) in Eastern and Southern Africa face parallel epidemics of unintended pregnancy and HIV. Their sexual health decisions are often dominated by intersecting stigmas. In an implementation science project integrating delivery of daily, oral pre-exposure prophylaxis (PrEP) for HIV prevention into 14 post-abortion care (PAC) clinics in Kenya, we enrolled a subset of PrEP initiating AGYW (aged 15 to 30 years) into a research cohort. Utilizing log binomial models, we estimated the effect of PrEP stigma on PrEP continuation (measured via self-report and urine assay for tenofovir) and abortion stigma on contraceptive initiation. Between April 2022 and February 2023, 401 AGYW were enrolled after initiating PrEP through their PAC provider, of which 120 (29.9%) initiated highly-effective contraception. Overall, abortion and PrEP stigmas were high in this cohort. Abortion stigma was more prevalent among those that were adolescents, unmarried, and reported social harm. Among 114 AGYW returning for the month 1 follow-up visit, 83.5% reported continuing PrEP and 52.5% had tenofovir detected. In this subset, higher levels of PrEP stigma were significantly associated with greater likelihood of PrEP adherence, but not PrEP continuation. For abortion stigma, greater scores in the subdomain of isolation were significantly associated with greater likelihood of initiating a highly-effective contraception, while greater scores in the subdomain of community condemnation were significantly associated with reduced likelihood of initiating a highly-effective contraception. Given the burden of stigma documented by our work, PAC settings are a pivotal space to integrate stigma-informed counseling and to empower young women to optimize contraceptive and PrEP decisions.

Indexed as

Abortion, InducedAnti-HIV AgentsHIV InfectionsPre-Exposure ProphylaxisSocial StigmaAdolescentAdultDecision MakingFamily Planning ServicesFemaleHumansKenyaPregnancyPregnancy, UnplannedTenofovirYoung AdultAnti-HIV AgentsTenofovirAbortionAdolescent girls and young womenPrEPStigma

Identifiers

PMID38451448
PMCPMC11161434
OpenAlexW4392553666

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.