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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
High acceptability of HIV pre-exposure prophylaxis but challenges in adherence and use: Qualitative insights from a phase i trial of intermittent and daily PrEP in at-risk populations in Kenya
AIDS and Behavior, Volume 17, No. 6, Year 2013
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Description
This paper used qualitative methods to explore experiences of men who have sex with men and female sex workers in Nairobi and Mtwapa, Kenya, who used oral pre-exposure prophylaxis (PrEP) for HIV prevention as part of a four-month trial of safety, acceptability and adherence. Fifty-one of 72 volunteers who took part in a randomized, placebo-controlled, blinded trial that compared daily and intermittent dosage of PrEP underwent qualitative assessments after completing the trial. Analyses identified three themes: (i) acceptability of PrEP was high, i.e. side effects were experienced early in the study but diminished over time, however characteristics of pills could improve comfort and use; (ii) social impacts such as stigma, rumors, and relationship difficulties due to being perceived as HIV positive were prevalent; (iii) adherence was challenged by complexities of daily life, in particular post-coital dosing adherence suffered from alcohol use around time of sex, mobile populations, and transactional sex work. These themes resonated across dosing regimens and gender, and while most participants favored the intermittent dosing schedule, those in the intermittent group noted particular challenges in adhering to the post-coital dose. Culturally appropriate and consistent counseling addressing these issues may be critical for PrEP effectiveness. © 2012 Springer Science+Business Media New York.
Authors & Co-Authors
van der Elst, Elise Maria
Kenya, Kilifi
Centre for Geographic Medicine Research
Mbogua, Judie
United States, New York
International Aids Vaccine Initiative
Operario, Don
United States, Providence
Brown University
Mutua, Gaudensia Nzembi
Kenya, Nairobi
Kenya Aids Vaccine Initiative
Kuo, Caroline C.
United States, Providence
Brown University
Mugo, Peter Mwangi
Kenya, Kilifi
Centre for Geographic Medicine Research
Kanungi, Jennifer
Kenya, Kilifi
Centre for Geographic Medicine Research
Singh, Sagri
United States, New York
International Aids Vaccine Initiative
Haberer, Jessica Elizabeth
United States, Boston
Massachusetts General Hospital
Priddy, Frances H.
United States, New York
International Aids Vaccine Initiative
Sanders, Eduard Joachim
Kenya, Kilifi
Centre for Geographic Medicine Research
United Kingdom, Oxford
Nuffield Department of Medicine
Statistics
Citations: 247
Authors: 11
Affiliations: 6
Identifiers
Doi:
10.1007/s10461-012-0317-8
ISSN:
10907165
Research Areas
Health System And Policy
Infectious Diseases
Substance Abuse
Study Approach
Qualitative
Study Locations
Kenya
Participants Gender
Male
Female