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Repeat Use of Post-exposure Prophylaxis for HIV Among Nairobi-Based Female Sex Workers Following Sexual Exposure

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Abstract

As ART-based prevention becomes available, effectively targeting these interventions to key populations such as female sex workers (FSW) will be critical. In this study we analyze patterns of repeated post-exposure prophylaxis (PEP) access in the context of a large FSW program in Nairobi. During close to 6000 person-years of follow-up, 20 % of participants (n = 1119) requested PEP at least once and 3.7 % requested PEP more than once. Repeat PEP users were younger, had a higher casual partner volume, and were more likely to use condoms with casual and regular partners, have a regular partner, and test for HIV prior to enrolment. Barriers to PEP included stigma, side effects, and lack of knowledge, suggesting repeated promotion may be required for higher rates of uptake. A small subset of FSW, potentially those with heightened risk perception, showed a higher frequency of PEP use; these individuals may be most amenable to rollout of pre-exposure prophylaxis.

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Acknowledgments

We would like to acknowledge and thank all the staff and participants of the SWOP clinic in Nairobi for their assistance with the completion of this study. Funding was provided by US-PEPFAR (CDC-PEPFAR U62/CCU024510-01) to L.G. and J.K. and CIHR MOP-89983 to R.K. R.K. is supported by an OHTN Career Scientist Award. L.R.M. was supported by a CIHR fellowship and the International Infectious Diseases and Global Health Training Program.

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Authors and Affiliations

  1. Kenya AIDS Control Project, Department of Medical Microbiology, University of Nairobi, PO Box 69555-00400, Nairobi, Kenya

    Preston Izulla, Lyle R. McKinnon, Julius Munyao, Naomi Ireri, Gloria Gakii, Lawrence Gelmon, Rupert Kaul & Joshua Kimani

  2. Department of Medicine, University of Toronto, Toronto, Canada

    Lyle R. McKinnon & Rupert Kaul

  3. Centre for the AIDS Program of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa

    Lyle R. McKinnon

  4. Department of Community Medicine, United Arab Emirates University, Al Ain, United Arab Emirates

    Nico Nagelkerke

  5. Department of Medical Microbiology, University of Manitoba, Winnipeg, Canada

    Nico Nagelkerke & Joshua Kimani

  6. School of Public Health, Moi University, Eldoret, Kenya

    Mabel Nangami

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  1. Preston Izulla
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  2. Lyle R. McKinnon
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  3. Julius Munyao
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  6. Gloria Gakii
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  7. Lawrence Gelmon
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  8. Mabel Nangami
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  9. Rupert Kaul
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  10. Joshua Kimani
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Correspondence to Preston Izulla.

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Izulla, P., McKinnon, L.R., Munyao, J. et al. Repeat Use of Post-exposure Prophylaxis for HIV Among Nairobi-Based Female Sex Workers Following Sexual Exposure. AIDS Behav 20, 1549–1555 (2016). https://doi.org/10.1007/s10461-015-1091-1

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  • DOI: https://doi.org/10.1007/s10461-015-1091-1

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