PrEP use and HIV seroconversion rates in adolescent girls and young women from Kenya and South Africa: the POWER demonstration project Article Swipe
Connie Celum
,
Elizabeth A. Bukusi
,
Linda‐Gail Bekker
,
Sinéad Delany‐Moretlwe
,
Lara Kidoguchi
,
Victor Omollo
,
Elzette Rousseau
,
Danielle Travill
,
Jennifer F. Morton
,
Felix Mogaka
,
Gabrielle O’Malley
,
Gena Barnabee
,
Ariane van der Straten
,
Deborah Donnell
,
Urvi M. Parikh
,
Lauren D. Kudrick
,
Peter L. Anderson
,
Jessica E. Haberer
,
Linxuan Wu
,
Renee Heffron
,
Rachel Johnson
,
Susan Morrison
,
Jared M. Baeten
·
YOU?
·
· 2022
· Open Access
·
· DOI: https://doi.org/10.1002/jia2.25962
YOU?
·
· 2022
· Open Access
·
· DOI: https://doi.org/10.1002/jia2.25962
Introduction HIV incidence remains high among African adolescent girls and young women (AGYW). The primary objective of this study is to assess pre‐exposure prophylaxis (PrEP) initiation, use, persistence and HIV acquisition among African AGYW offered PrEP in order to inform PrEP scale‐up. Methods POWER was a prospective implementation science evaluation of PrEP delivery for sexually active HIV‐negative AGYW ages 16–25 in family planning clinics in Kisumu, Kenya and youth and primary healthcare clinics in Cape Town and Johannesburg, South Africa. Follow‐up visits occurred at month 1 and quarterly for up to 36 months. PrEP users were defined based on the month 1 refill. PrEP persistence through month 6 was assessed using Kaplan–Meier survival analysis among AGYW with a month 1 visit, defining non‐persistence as an ≥15 day gap in PrEP availability for daily dosing. PrEP execution was evaluated in a subset with PrEP supply from the prior visit sufficient for daily dosing by measuring blood tenofovir diphosphate (TFV‐DP) levels. Results From June 2017 to September 2020, 2550 AGYW were enrolled (1000 in Kisumu, 787 in Cape Town and 763 in Johannesburg). Median age was 21 years, 66% had a sexual partner of unknown HIV status, and 29% had chlamydia and 10% gonorrhoea. Overall, 2397 (94%) initiated PrEP and 749 (31%) had a refill at 1 month. Of AGYW who could reach 6 months of post‐PrEP initiation follow‐up, 128/646 (20%) persisted with PrEP for 6 months and an additional 92/646 (14%) had a gap and restarted PrEP. TFV‐DP levels indicated that 47% (91/193) took an average of ≥4 doses/week. Sixteen HIV seroconversions were observed (incidence 2.2 per 100 person‐years, 95% CI 1.2, 3.5); 13 (81%) seroconverters either did not have PrEP dispensed in the study interval prior to seroconversion or TFV‐DP levels indicated <4 doses/week in the prior 6 weeks. Conclusions In this study of PrEP integration with primary care and reproductive health services for African AGYW, demand for PrEP was high. Although PrEP use decreased in the first months, an important fraction used PrEP through 6 months. Strategies are needed to simplify PrEP delivery, support adherence and offer long‐acting PrEP options to improve persistence and HIV protection.
Related Topics
Concepts
Medicine
Pre-exposure prophylaxis
Human immunodeficiency virus (HIV)
Seroconversion
Chlamydia
Dosing
Demography
Pediatrics
Family medicine
Men who have sex with men
Internal medicine
Immunology
Syphilis
Sociology
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1002/jia2.25962
- OA Status
- gold
- Cited By
- 86
- References
- 32
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4285097758
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4285097758Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1002/jia2.25962Digital Object Identifier
- Title
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PrEP use and HIV seroconversion rates in adolescent girls and young women from Kenya and South Africa: the POWER demonstration projectWork title
- Type
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articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2022Year of publication
- Publication date
-
2022-07-01Full publication date if available
- Authors
-
Connie Celum, Elizabeth A. Bukusi, Linda‐Gail Bekker, Sinéad Delany‐Moretlwe, Lara Kidoguchi, Victor Omollo, Elzette Rousseau, Danielle Travill, Jennifer F. Morton, Felix Mogaka, Gabrielle O’Malley, Gena Barnabee, Ariane van der Straten, Deborah Donnell, Urvi M. Parikh, Lauren D. Kudrick, Peter L. Anderson, Jessica E. Haberer, Linxuan Wu, Renee Heffron, Rachel Johnson, Susan Morrison, Jared M. BaetenList of authors in order
- Landing page
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https://doi.org/10.1002/jia2.25962Publisher landing page
- Open access
-
YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
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https://doi.org/10.1002/jia2.25962Direct OA link when available
- Concepts
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Medicine, Pre-exposure prophylaxis, Human immunodeficiency virus (HIV), Seroconversion, Chlamydia, Dosing, Demography, Pediatrics, Family medicine, Men who have sex with men, Internal medicine, Immunology, Syphilis, SociologyTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
86Total citation count in OpenAlex
- Citations by year (recent)
-
2025: 23, 2024: 32, 2023: 22, 2022: 5, 2021: 3Per-year citation counts (last 5 years)
- References (count)
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32Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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| corresponding_author_ids | https://openalex.org/A5090773831 |
| countries_distinct_count | 3 |
| institutions_distinct_count | 23 |
| corresponding_institution_ids | https://openalex.org/I201448701 |
| sustainable_development_goals[0].id | https://metadata.un.org/sdg/3 |
| sustainable_development_goals[0].score | 0.8399999737739563 |
| sustainable_development_goals[0].display_name | Good health and well-being |
| citation_normalized_percentile.value | 0.98576581 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | True |