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I Knew I Would Be Safer. Experiences of Kenyan HIV Serodiscordant Couples Soon After Pre-Exposure Prophylaxis (PrEP) Initiation.
AIDS Patient Care STDS. 2016 Feb; 30(2):78-83.AP

Abstract

Pre-exposure prophylaxis (PrEP) for HIV-uninfected persons is highly efficacious for HIV prevention. Understanding how people at risk for HIV will use PrEP is important to inform PrEP scale-up and implementation. We used qualitative methods to gather insights into couples' early experiences with PrEP use within the Partners Demonstration Project, an open-label implementation study evaluating integrated delivery of PrEP and antiretroviral therapy (ART). PrEP is offered to HIV uninfected partners until the HIV-infected partner initiates and sustains ART use (i.e., PrEP as a "bridge" to ART initiation and viral suppression). From August 2013 to March 2014 we conducted 20 in-depth dyadic interviews (n = 40) with heterosexual HIV serodiscordant couples participating at the Thika, Kenya study site, exploring how couples make decisions about using PrEP for HIV prevention. We developed and applied deductive and inductive codes to identify key themes related to experiences of PrEP initiation and use of time-limited PrEP. Couples reported that PrEP offered them an additional strategy to reduce the risk of HIV transmission, meet their fertility desires, and cope with HIV serodiscordance. Remaining HIV negative at follow-up visits reinforced couples' decisions and motivated continued adherence to PrEP. In addition, confidence in their provider's advice and client-friendly services were critical to their decisions to initiate and continue use of PrEP. Strategies for wide-scale PrEP delivery for HIV serodiscordant couples in low resource settings may include building capacity of health providers to counsel on PrEP adoption while addressing couples' concerns and barriers to adoption and continued use.

Authors+Show Affiliations

1 School of Public Health, Jomo Kenyatta University of Agriculture and Technology , Kenya . 2 Department of Global Health, University of Washington , Seattle, Washington.2 Department of Global Health, University of Washington , Seattle, Washington. 3 Department of Epidemiology, University of Washington , Seattle, Washington.2 Department of Global Health, University of Washington , Seattle, Washington.5 Center for Clinical Research, Kenya Medical Research Institute , Kenya .5 Center for Clinical Research, Kenya Medical Research Institute , Kenya .2 Department of Global Health, University of Washington , Seattle, Washington. 5 Center for Clinical Research, Kenya Medical Research Institute , Kenya .2 Department of Global Health, University of Washington , Seattle, Washington. 3 Department of Epidemiology, University of Washington , Seattle, Washington. 4 Department of Medicine, University of Washington , Seattle, Washington.2 Department of Global Health, University of Washington , Seattle, Washington. 3 Department of Epidemiology, University of Washington , Seattle, Washington. 4 Department of Medicine, University of Washington , Seattle, Washington.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

26836236

Citation

Ngure, Kenneth, et al. "I Knew I Would Be Safer. Experiences of Kenyan HIV Serodiscordant Couples Soon After Pre-Exposure Prophylaxis (PrEP) Initiation." AIDS Patient Care and STDs, vol. 30, no. 2, 2016, pp. 78-83.
Ngure K, Heffron R, Curran K, et al. I Knew I Would Be Safer. Experiences of Kenyan HIV Serodiscordant Couples Soon After Pre-Exposure Prophylaxis (PrEP) Initiation. AIDS Patient Care STDS. 2016;30(2):78-83.
Ngure, K., Heffron, R., Curran, K., Vusha, S., Ngutu, M., Mugo, N., Celum, C., & Baeten, J. M. (2016). I Knew I Would Be Safer. Experiences of Kenyan HIV Serodiscordant Couples Soon After Pre-Exposure Prophylaxis (PrEP) Initiation. AIDS Patient Care and STDs, 30(2), 78-83. https://doi.org/10.1089/apc.2015.0259
Ngure K, et al. I Knew I Would Be Safer. Experiences of Kenyan HIV Serodiscordant Couples Soon After Pre-Exposure Prophylaxis (PrEP) Initiation. AIDS Patient Care STDS. 2016;30(2):78-83. PubMed PMID: 26836236.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - I Knew I Would Be Safer. Experiences of Kenyan HIV Serodiscordant Couples Soon After Pre-Exposure Prophylaxis (PrEP) Initiation. AU - Ngure,Kenneth, AU - Heffron,Renee, AU - Curran,Kathyrn, AU - Vusha,Sophie, AU - Ngutu,Mariah, AU - Mugo,Nelly, AU - Celum,Connie, AU - Baeten,Jared M, PY - 2016/2/3/entrez PY - 2016/2/3/pubmed PY - 2016/6/23/medline SP - 78 EP - 83 JF - AIDS patient care and STDs JO - AIDS Patient Care STDS VL - 30 IS - 2 N2 - Pre-exposure prophylaxis (PrEP) for HIV-uninfected persons is highly efficacious for HIV prevention. Understanding how people at risk for HIV will use PrEP is important to inform PrEP scale-up and implementation. We used qualitative methods to gather insights into couples' early experiences with PrEP use within the Partners Demonstration Project, an open-label implementation study evaluating integrated delivery of PrEP and antiretroviral therapy (ART). PrEP is offered to HIV uninfected partners until the HIV-infected partner initiates and sustains ART use (i.e., PrEP as a "bridge" to ART initiation and viral suppression). From August 2013 to March 2014 we conducted 20 in-depth dyadic interviews (n = 40) with heterosexual HIV serodiscordant couples participating at the Thika, Kenya study site, exploring how couples make decisions about using PrEP for HIV prevention. We developed and applied deductive and inductive codes to identify key themes related to experiences of PrEP initiation and use of time-limited PrEP. Couples reported that PrEP offered them an additional strategy to reduce the risk of HIV transmission, meet their fertility desires, and cope with HIV serodiscordance. Remaining HIV negative at follow-up visits reinforced couples' decisions and motivated continued adherence to PrEP. In addition, confidence in their provider's advice and client-friendly services were critical to their decisions to initiate and continue use of PrEP. Strategies for wide-scale PrEP delivery for HIV serodiscordant couples in low resource settings may include building capacity of health providers to counsel on PrEP adoption while addressing couples' concerns and barriers to adoption and continued use. SN - 1557-7449 UR - https://www.unboundmedicine.com/medline/citation/26836236/I_Knew_I_Would_Be_Safer__Experiences_of_Kenyan_HIV_Serodiscordant_Couples_Soon_After_Pre_Exposure_Prophylaxis__PrEP__Initiation_ L2 - https://www.liebertpub.com/doi/full/10.1089/apc.2015.0259?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -