Episodic Use of Pre-Exposure Prophylaxis Among Young Cisgender Women in Siaya County, Kenya

作者：Amy Corneli, Brian Perry, Duncan Ochieng Ngoje, Nneka Molokwu, Robert W. Strack, Kawango Agot · 发表于：AIDS Patient Care and STDs · 年份：2022 · DOI：10.1089/apc.2022.0076 · 被引用次数：11 · 研究领域：HIV/AIDS Research and Interventions、Adolescent Sexual and Reproductive Health、Sex work and related issues

The concept “seasons of risk” promotes use of pre-exposure prophylaxis (PrEP) only during periods of HIV risk. PrEP guidelines are aligned on daily use in women having vaginal sex during a risk period, and daily use for 28 days after the last potential exposure is recommended. However, when starting a “season of risk,” guidelines vary on “time to protection,” and unknowns remain in pharmacological research on PrEP protection in this population. During our iterative research on PrEP persistence using photovoice and in-depth interviews, we identified an ineffective pattern of PrEP use based on current guidelines—that is, routine, episodic use—among young cisgender women (YCW) in Siaya County, Kenya. Through same-group (n = 33 participants) and mixed-group (n = 31 participants) photovoice activities with YCW taking PrEP and female peers, participants explained that YCW associate their HIV risk with the sexual behaviors of their male partners who frequently travel from home. PrEP is considered unnecessary when partners are away because of no perceived risk. YCW re-start PrEP on or around the day of their partners' return because of heightened risk perceptions. Among the YCW interviewed (n = 18), nearly all of their partners traveled for about 1 week to 1 month at a time; about one-third of these women reported stopping PrEP during their partners' absence and re-starting it soon before or immediately upon their partners' arrival home. Additional research is critically needed to be...