Trajectories of Oral PrEP Adherence Among Young Kenyan Women: Implications for Promoting Effective PrEP Use

• DOI: 10.1007/s10461-022-03753-y
• Publication Date: 2022-07-16T12:02:43Z
• Authors: Nicholas Musinguzi; Maria Pyra; Elizabeth A. Bukusi; Nelly R. Mugo; Jared M. Baeten; Jessica E. Haberer; ; Jessica E Haberer; Jared M Baeten; Elizabeth Bukusi; Nelly Mugo; Kenneth Ngure; Ruanne Barnabas; Harsha Thirumurthy; Ingrid Katz; Kevin Kamolloh; Josephine Odoyo; Linda Aswani; Lawrence Juma; Elizabeth Koyo; Bernard Rono; Stanley Cheruiot; Vallery Ogello; Loice Okumu; Violet Kwach; Alfred Obiero; Stella Njuguna; Millicent Faith A...; Lilian Adipo; Sylvia Akinyi; Catherine Kiptiness; Nicholas Thuo; Stephen Gakuo Maina; Irene Njeru; Peter Mogere; Sarah Mbaire; Murugi Micheni; Lynda Oluoch; John Njoroge; Snaidah Ongachi; Jacinta Nyokabi; Lindsey Garrison; Maria Pyra; Kathleen K Thomas; Nicholas Musinguzi; Susie Valenzuela; Susan Morrison
• Keywords: 03 medical and health sciences; 0302 clinical medicine; Anti-HIV Agents; Risk Factors; Humans; Female; HIV Infections; Pre-Exposure Prophylaxis; Kenya; Medication Adherence

Using data from a 2-year study of young women at high HIV risk in Thika and Kisumu, Kenya, we identified group-based trajectories of PrEP adherence based on electronic pillcap-monitoring and assessed potentially associated demographic and socio-behavioral factors. Among 348 women, we selected a three-trajectory adherence model: low and declining (N = 211, 61%), moderate but declining (N = 119, 34%) and steady high adherers (N = 18, 5%). We also identified a two-trajectory HIV risk model based on self-perceived risk in the past week: high and increasing (N = 28, 8%) and steady low (N = 320, 92%) risk. The Kisumu site was associated with the moderate but declining and steady high adherence trajectories, while increasing VOICE risk score was associated with the low and declining adherence trajectory. We found no association between the adherence and risk trajectories. Our findings suggest adherence support may need tailoring by setting. Early, sustained support may also help those at highest risk of non-adherence.