Online Program

Gender-specific awareness and acceptability of pre-exposure prophylaxis to prevent HIV infection among youth in western Kenya: Implications for combination HIV prevention

Wednesday, November 6, 2013

Ann Kurth, PhD, CNM, FAAN, NYU College of Nursing, New York University, New York City, NY
Jasmine Buttolph, MPH, New York University, New York, NY
Charles M Cleland, PhD, NYU College of Nursing, New York University, New York City, NY
Irene Inwani, MD, MPH, University of Nairobi, University of Nairobi, Nairobi, Kenya
Kawango Agot, PhD, MPH, Impact Research and Development Organization, Kisumu, Kenya
Eunice Omanga, PhD, Impact Research and Development Organization, Kisumu, Kenya
Youth ages 15-24 in sub-Saharan Africa are more impacted by HIV/AIDS than any other group globally. In Kenya, young females are 4-times more likely to be positive than males. Gender-specific HIV prevention combining behavioral, structural, and biomedical modalities is necessary to impact the epidemic. Trials of pre-exposure prophylaxis (PrEP) showed efficacy in reducing HIV risk when adherence >=85%. The study analyzed youth knowledge, acceptability, facilitators, and barriers to PrEP adherence, which influence intervention efficacy. Focus groups were conducted in Nyanza, Kenya composed of youth ages 15-24, parents and teachers of youth, and community, district, and religious leaders. Forty six females and 66 males participated (n=112). A content analysis identified themes and sub-themes related to PrEP. Four major themes emerged: (1) limited knowledge of PrEP as an HIV prevention method; (2) PrEP advantages; (3) concern about side-effects; (4) potential risk compensation. Sub-themes highlighted a desire for sensitization campaigns, the idea of PrEP as life saving, and adherence challenges. Findings indicate a need for increased PrEP awareness. Youth expressed willingness to use PrEP when coupled with pre-counseling and adherence support. Adherence to the PrEP is linked to knowledge, widespread use, and acceptability. Adherence remains a challenge with variability in access, risk-perceptions, and concerns about side-effects. Some participants believed HIV risk-reduction outweighed potential side-effects. Participants indicated PrEP could be effective for HIV prevention. Considering the efficacy of PrEP trials, combination HIV prevention studies should explore incorporating PrEP. Interventions need to provide gender-specific options to reduce PrEP misconceptions, reduce risk compensation, and support adherence.

Learning Areas:

Planning of health education strategies, interventions, and programs

Learning Objectives:
Describe the major themes associated youth perceptions of PrEP as a method of HIV prevention. Evaluate youth and community concerns surrounding PrEP use. Discuss challenges of incorporating PrEP into gender-specific combination HIV prevention packages.

Keyword(s): Youth, HIV Interventions

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an associate research scientist in global health at NYU and am the project manager of the MP3 Youth pilot study. I have conducted a systematic review on gender-specific combination HIV prevention interventions and qualitative research on gender-specific acceptability of Pre-Exposure Prophylaxis. I am from the Caribbean and have additionally lived and worked in North Africa/Middle East and East Africa.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.