دورية أكاديمية
"I wish to remain HIV negative": Pre-exposure prophylaxis adherence and persistence in transgender women and men who have sex with men in coastal Kenya.
| العنوان: | "I wish to remain HIV negative": Pre-exposure prophylaxis adherence and persistence in transgender women and men who have sex with men in coastal Kenya. |
|---|---|
| المؤلفون: | Kimani M; KEMRI-Wellcome Trust Research Program, Kilifi, Kenya., van der Elst EM; KEMRI-Wellcome Trust Research Program, Kilifi, Kenya., Chirro O; KEMRI-Wellcome Trust Research Program, Kilifi, Kenya., Wahome E; KEMRI-Wellcome Trust Research Program, Kilifi, Kenya., Ibrahim F; Department of Health, Kilifi County, Kilifi, Kenya., Mukuria N; KEMRI-Wellcome Trust Research Program, Kilifi, Kenya., de Wit TFR; Department of Global Health, Amsterdam Institute for Global Health and Development, University of Amsterdam, Amsterdam, Netherlands., Graham SM; Department of Global Health, University of Washington, Seattle, Washington, United States of America., Operario D; Department of Public Health, Brown University, Providence, Rhode Island, United States of America., Sanders EJ; KEMRI-Wellcome Trust Research Program, Kilifi, Kenya.; Nufield Department of Medicine, Oxford University, Oxford, United Kingdom. |
| المصدر: | PloS one [PLoS One] 2021 Jan 19; Vol. 16 (1), pp. e0244226. Date of Electronic Publication: 2021 Jan 19 (Print Publication: 2021). |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: San Francisco, CA : Public Library of Science |
| مواضيع طبية MeSH: | Pre-Exposure Prophylaxis*, Anti-HIV Agents/*therapeutic use , HIV Infections/*prevention & control , Homosexuality, Male/*psychology , Transgender Persons/*psychology, Adolescent ; Adult ; Anti-HIV Agents/analysis ; Dried Blood Spot Testing ; Health Risk Behaviors ; Humans ; Interviews as Topic ; Kenya ; Male ; Medication Adherence ; Tenofovir/analysis ; Tenofovir/therapeutic use ; Young Adult |
| مستخلص: | Background: Transgender women (TGW) and men who have sex with men (MSM) in sub-Saharan Africa have high HIV acquisition risks and can benefit from daily pre-exposure prophylaxis (PrEP). We assessed PrEP adherence by measuring tenofovir-diphosphate (TFV-DP) levels and explore motives for PrEP persistence in TGW and MSM. Methods: Participants were enrolled in a one-year PrEP programme and made quarterly visits irrespective of whether they were still using PrEP. At their month 6 visit, participants provided a dried blood spot to test for TFV-DP levels; protective levels were defined as those compatible with ≥4 pills per week (700-1249 fmol/punch). Before TFV-DP levels were available, a sub-set of these participants were invited for an in-depth interview (IDI). Semi-structured IDI topic guides were used to explore motives to uptake, adhere to, and discontinue PrEP. IDI data were analyzed thematically. Results: Fifty-three participants (42 MSM and 11 TGW) were enrolled. At month 6, 11 (20.7%) participants (8 MSM and 3 TGW) were lost to follow up or stopped taking PrEP. Any TFV-DP was detected in 62.5% (5/8) of TGW vs. 14.7% of MSM (5/34, p = 0.01). Protective levels were detected in 37.5% of TGW (3/8), but not in any MSM. Nineteen IDI were conducted with 7 TGW and 9 MSM on PrEP, and 1 TGW and 2 MSM off PrEP. Unplanned or frequent risky sexual risk behaviour were the main motives for PrEP uptake. Among participants on PrEP, TGW had a more complete understanding of the benefits of PrEP. Inconsistent PrEP use was attributed to situational factors. Motives to discontinue PrEP included negative reactions from partners and stigmatizing healthcare services. Conclusion: While MSM evinced greater adherence challenges in this PrEP programme, almost 40% of TGW were protected by PrEP. Given high HIV incidences in TGW these findings hold promise for TGW PrEP programming in the region. Competing Interests: The authors have declared that no competing interests exist. |
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| معلومات مُعتمدة: | United Kingdom WT_ Wellcome Trust; R25 MH067127 United States MH NIMH NIH HHS; 107752/Z/15/Z United Kingdom WT_ Wellcome Trust |
| المشرفين على المادة: | 0 (Anti-HIV Agents) 99YXE507IL (Tenofovir) |
| تواريخ الأحداث: | Date Created: 20210119 Date Completed: 20210423 Latest Revision: 20220304 |
| رمز التحديث: | 20240628 |
| مُعرف محوري في PubMed: | PMC7815127 |
| DOI: | 10.1371/journal.pone.0244226 |
| PMID: | 33465090 |
| قاعدة البيانات: | MEDLINE |
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