Evidence map›Paper›PMID 40268677›Full record

Trial reportJournal of the International AIDS Society2025

"It gives me the strength and courage to take care of myself": a qualitative exploration of experiences with STI testing among women who initiated PrEP during pregnancy in Western Kenya.

Jerusha N Mogaka, Tessa Concepcion, Felix Abuna, Eunita Akim, Chelsea Morroni, Aamirah Mussa, Melissa Mugambi, Helen Aketch, Sarah Obatsa, Allison R Webel and 5 more

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the International AIDS Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04472884 (mWACh-PrEP), which is not on this map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–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.

NCT04472884 naunknown statusnot on this map

mWACh-PrEP: A SMS-based Support Intervention to Enhance PrEP Adherence During Pregnancy and Breastfeeding

TypeinterventionalSponsorUniversity of WashingtonRan2022 to 2025Enrolled600ConditionsHIV Infections, Pregnancy Related, Adherence, MedicationArmsmWACh-PrEP, Standard of Care
3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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

15 authors.

Jerusha N MogakaSchool of Nursing, University of Washington, Seattle, Washington, USA.ORCID https://orcid.org/0000-0001-9913-9034
Tessa ConcepcionDepartment of Global Health, University of Washington, Seattle, Washington, USA.
Felix AbunaResearch and Programs Department, Kenyatta National Hospital, Nairobi, Kenya.
Eunita AkimResearch and Programs Department, Kenyatta National Hospital, Nairobi, Kenya.
Chelsea MorroniBotswana Harvard Health Partnership, Gaborone, Botswana.
Aamirah MussaBotswana Harvard Health Partnership, Gaborone, Botswana.
Melissa MugambiDepartment of Global Health, University of Washington, Seattle, Washington, USA.ORCID https://orcid.org/0000-0001-8875-5528
Helen AketchResearch and Programs Department, Kenyatta National Hospital, Nairobi, Kenya.
Sarah ObatsaResearch and Programs Department, Kenyatta National Hospital, Nairobi, Kenya.
Allison R WebelSchool of Nursing, University of Washington, Seattle, Washington, USA.
John KinuthiaDepartment of Global Health, University of Washington, Seattle, Washington, USA.
Kenneth NgureDepartment of Community Health, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya.
Kristin M Beima-SofieDepartment of Global Health, University of Washington, Seattle, Washington, USA.
Grace John-StewartDepartment of Global Health, University of Washington, Seattle, Washington, USA.
Jillian PintyeSchool of Nursing, University of Washington, Seattle, Washington, USA.ORCID https://orcid.org/0000-0003-1255-7191

Funding

University of Washington/Fred Hutch Center for AIDS ResearchP30AI027757 · NIAID · UNIVERSITY OF WASHINGTON · PI CONNIE L CELUM · 1988 to 2026
$104.9M
mWACh-PrEP: A SMS-based Support Intervention to Enhance PrEP Adherence during Pregnancy and BreastfeedingR01NR019220 · NINR · UNIVERSITY OF WASHINGTON · PI KINUTHIA, JOHN, PINTYE, JILLIAN · 2020 to 2024
$2.9M
Eunice Kennedy Shriver National Institute of Child Health and Human Development R01HD100201Eunice Kennedy Shriver National Institute of Child Health and Human Development R01HD108041Eunice Kennedy Shriver National Institute of Child Health and Human Development R01HD113455Eunice Kennedy Shriver National Institute of Child Health & Human Development R01HD100201Eunice Kennedy Shriver National Institute of Child Health & Human Development R01HD108041Eunice Kennedy Shriver National Institute of Child Health & Human Development R01HD113455Eunice Kennedy Shriver National Institute of Child Health & Human Development R01HD117702NIAID NIH HHS P30 AI027757NINR NIH HHS R01NR019220University of Washington's Global Center for Integrated Health of Women, Adolescents, and Children (Global WACh)
6 · The paper itself

Abstract

introductionSexually transmitted infections (STIs) in pregnancy contribute to poor perinatal outcomes and increased HIV acquisition risk, underscoring the importance of delivering STI/HIV services within antenatal care. Few studies evaluate women's perspectives on the co-delivery of antenatal STI testing and HIV pre-exposure prophylaxis (PrEP). We sought to understand motivations for and experiences with STI testing among pregnant women who initiated HIV PrEP.

methodsWe conducted semi-structured in-depth interviews (IDIs) among a subset of women enrolled in a randomized trial in Western Kenya (NCT04472884) who initiated PrEP within antenatal clinics and tested for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) in pregnancy and/or postpartum. As part of parent study procedures, IDIs were conducted between September 2023 and April 2024. Interviews were recorded, transcribed and thematically analysed using deductive and inductive methods. The Health Belief Model guided exploration of STI testing experiences, motivations for testing and the impact of testing on PrEP use.

resultsOverall, 39 women who initiated PrEP during pregnancy and tested for CT/NG participated in IDIs; six tested positive for CT and/or NG. Median age was 26 years (IQR 21-29), 77% of participants had >8 years of education, 15% were employed and 72% were married. Most (86%) did not know their partner's HIV status, and 82% persisted with PrEP use at 9 months postpartum. Perceived vulnerability to STI/HIV acquisition, fear of adverse outcomes from untreated infections (e.g. pregnancy loss or harm to baby) and desire to alleviate symptoms (e.g. abnormal discharge) motivated STI testing uptake when offered during antenatal visits. Provision of STI-related education, availability of STI services (i.e. immediate treatment, expedited partner therapy) and supportive interactions with providers promoted positive experiences with STI testing. STI testing encouraged health-promoting behaviours, including sustained PrEP use, even when STI results were negative, as testing made women feel proactively involved in preventing HIV/STI complications for themselves and their infants.

conclusionsIn this qualitative evaluation among women who initiated PrEP in pregnancy, STI testing encouraged PrEP use, even when results were negative. Incorporating STI testing within PrEP delivery in antenatal care represents an opportunity for addressing HIV/STI in this priority population.

Indexed as

HIV InfectionsPre-Exposure ProphylaxisPregnancy Complications, InfectiousSexually Transmitted DiseasesAdultChlamydia InfectionsFemaleGonorrheaHumansKenyaMotivationPatient Acceptance of Health CarePregnancyPrenatal CareQualitative ResearchYoung Adultpregnant and postpatum womenPrEPrisk perceptionsexually transmitted infectionsSTI testinguser experiences

Identifiers

PMID40268677
PMCPMC12018012

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.