Evidence map›Paper›PMID 39496511›Full record

ArticleJournal of the International AIDS Society2024

Pre-exposure prophylaxis implementation gaps among people vulnerable to HIV acquisition: a cross-sectional analysis in two communities in western Kenya, 2021-2023.

Matthew L Romo, Glenna Schluck, Josphat Kosgei, Christine Akoth, Rael Bor, Deborah Langat, Curtisha Charles, Paul Adjei, Britt Gayle, Elyse LeeVan and 7 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the International AIDS Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–field-weighted citation impact
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

9 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Observational
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.

Matthew L RomoU.S. Military HIV Research Program, CIDR, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.ORCID https://orcid.org/0000-0002-3038-0644
Glenna SchluckU.S. Military HIV Research Program, CIDR, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Josphat KosgeiU.S. Military HIV Research Program, Walter Reed Army Institute of Research - Africa, Kericho, Kenya.
Christine AkothU.S. Military HIV Research Program, Walter Reed Army Institute of Research - Africa, Kericho, Kenya.
Rael BorU.S. Military HIV Research Program, Walter Reed Army Institute of Research - Africa, Kericho, Kenya.
Deborah LangatU.S. Military HIV Research Program, Walter Reed Army Institute of Research - Africa, Kericho, Kenya.
Curtisha CharlesU.S. Military HIV Research Program, CIDR, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Paul AdjeiU.S. Military HIV Research Program, CIDR, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Britt GayleU.S. Military HIV Research Program, CIDR, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Elyse LeeVanNational Cancer Institute, National Institutes of Health, Rockville, Maryland, USA.ORCID https://orcid.org/0000-0002-2581-9747
David ChangU.S. Military HIV Research Program, CIDR, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Adam YatesU.S. Military HIV Research Program, CIDR, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Margaret YacovoneNational Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland, USA.
Julie A AkeU.S. Military HIV Research Program, CIDR, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
Fred SaweU.S. Military HIV Research Program, Walter Reed Army Institute of Research - Africa, Kericho, Kenya.
Trevor A CrowellU.S. Military HIV Research Program, CIDR, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.ORCID https://orcid.org/0000-0001-5947-265X
Multinational Observational Cohort of HIV and other Infections (MOCHI) Study Group

Funding

U.S. Department of DefenseU.S. National Institute of Allergy and Infectious Diseases
6 · The paper itself

Abstract

introductionDespite the increasing availability of prevention tools like pre-exposure prophylaxis (PrEP), HIV incidence remains disproportionately high in sub-Saharan Africa. We examined PrEP awareness, uptake and persistence among participants enrolling into an HIV incidence cohort in Kenya.

methodsWe used cross-sectional enrolment data from the Multinational Observational Cohort of HIV and other Infections (MOCHI) in Homa Bay and Kericho, Kenya. The cohort recruited individuals aged 14-55 years with a recent history of sexually transmitted infection, transactional sex, condomless sex and/or injection drug use. Participants completed questionnaires on PrEP, demographics and sexual behaviours. We used multivariable robust Poisson regression to estimate adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) for associations with never hearing of PrEP, never taking PrEP and ever stopping PrEP.

resultsBetween 12/2021 and 5/2023, 399 participants attempted the PrEP questionnaire, of whom 316 (79.2%) were female and median age was 22 years (interquartile range 19-24); 316 of 390 participants (81.0%) engaged in sex work or transactional sex. Of 396 participants who responded to the question, 120 (30.3%) had never heard of PrEP. Of 275 participants who had heard of PrEP, 206 (74.9%) had never taken it. Of 69 participants who had ever taken PrEP, 50 (72.5%) stopped it at some time prior to enrolment. Participants aged 15-19 years more often reported never taking PrEP compared with those 25-36 years (aPR 1.31, 95% CI: 1.06-1.61). Participants who knew someone who took PrEP less often reported never hearing about PrEP (aPR 0.10, 95% CI: 0.04-0.23) and never taking PrEP (aPR: 0.69, 95% CI: 0.60-0.80). Stopping PrEP was more common among participants with a weekly household income ≤1000 versus >1000 Kenyan shillings (aPR 1.40, 95% CI: 1.02-1.93) and those using alcohol/drugs before sex (aPR 1.53, 95% CI: 1.03-2.26). Stopping PrEP was less common among those engaging in sex work or transactional sex (aPR 0.6, 95% CI: 0.40-0.92).

conclusionsWe identified substantial gaps in PrEP awareness, uptake and persistence, which were associated with potential system- and individual-level risk factors. Our analyses also highlight the importance of increasing PrEP engagement among individuals who do not know others taking PrEP.

Indexed as

HIV InfectionsPre-Exposure ProphylaxisAdolescentAdultAnti-HIV AgentsCross-Sectional StudiesFemaleHealth Knowledge, Attitudes, PracticeHumansKenyaMaleMiddle AgedSexual BehaviorSurveys and QuestionnairesYoung AdultAnti-HIV AgentsHIVimplementation scienceKenyapre‐exposure prophylaxissocial determinants of healthtenofovir

Identifiers

PMID39496511
PMCPMC11534481

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.