Early Adopters of Human Immunodeficiency Virus Pre-exposure Prophylaxis in a Population-based Combination Prevention Study in Rural Kenya and Uganda

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dc.contributor.authorKoss, Catherine A.
dc.contributor.authorAyieko, James
dc.contributor.authorMwangwa, Florence
dc.contributor.authorOwaraganise, Asiphas
dc.contributor.authorKwarisiima, Dalsone
dc.contributor.authorKabami, Jane
dc.contributor.authorBukusi, Elizabeth A.
dc.contributor.authorCharlebois, Edwin D.
dc.contributor.authorPetersen, Maya L.
dc.contributor.authorKamya, Moses R.
dc.contributor.authorHavlir, Diane V.
dc.contributor.authorfor the SEARCH Collaboration
dc.date.accessioned2022-08-23T20:38:06Z
dc.date.available2022-08-23T20:38:06Z
dc.date.issued2018
dc.description.abstractGlobal guidelines recommend preexposure prophylaxis (PrEP) for individuals with substantial human immunodeficiency virus (HIV) risk. Data on PrEP uptake in sub-Saharan Africa outside of clinical trials are limited. We report on “early adopters” of PrEP in the Sustainable East Africa Research in Community Health (SEARCH) study in rural Uganda and Kenya. After community mobilization and PrEP education, population-based HIV testing was conducted. HIV-uninfected adults were offered PrEP based on an empirically derived HIV risk score or self-identified HIV risk (if not identified by score). Using logistic regression, we analyzed predictors of early PrEP adoption (starting PrEP within 30 days vs delayed/no start) among adults identified for PrEP. Of 21212 HIV-uninfected adults in 5 communities, 4064 were identified for PrEP (2991 by empiric risk score, 1073 by self-identified risk). Seven hundred and thirty nine individuals started PrEP within 30 days (11% of those identified by risk score; 39% of self-identified); 77% on the same day. Among adults identified by risk score, predictors of early adoption included male sex (adjusted odds ratio 1.53; 95% confidence interval, 1.09–2.15), polygamy (1.92; 1.27–2.90), serodiscordant spouse (3.89; 1.18–12.76), self-perceived HIV risk (1.66; 1.28–2.14), and testing at health campaign versus home (5.24; 3.33–8.26). Among individuals who self-identified for PrEP, predictors of early adoption included older age (2.30; 1.29–4.08) and serodiscordance (2.61; 1.01–6.76). Implementation of PrEP incorporating a population-based empiric risk score, self-identified risk, and rapid initiation, is feasible in rural East Africa. Strategies are needed to overcome barriers to PrEP uptake, particularly among women and youth.en_US
dc.identifier.citationKoss, C. A., Ayieko, J., Mwangwa, F., Owaraganise, A., Kwarisiima, D., Balzer, L. B., ... & SEARCH Collaboration. (2018). Early adopters of human immunodeficiency virus preexposure prophylaxis in a population-based combination prevention study in rural Kenya and Uganda. Clinical Infectious Diseases, 67(12), 1853-1860.https://doi.org/10.1093/cid/ciy390en_US
dc.identifier.issn1537-6591
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/4397
dc.language.isoenen_US
dc.publisherClinical Infectious Diseasesen_US
dc.subjectHIV prevention; preexposure prophylaxis; serodiscordant couple; HIV risken_US
dc.titleEarly Adopters of Human Immunodeficiency Virus Pre-exposure Prophylaxis in a Population-based Combination Prevention Study in Rural Kenya and Ugandaen_US
dc.typeArticleen_US
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