“When he is around, I’ll take the PrEP, but when he is not, I will not take PrEP”: key influences on PrEP use decisions among women attending family planning clinics in Kenya Article Swipe
Vallery Ogello
,
Kristin Beima‐Sofie
,
Sandra Urusaro
,
Mercy Awuor
,
Annabell Dollah
,
Winnie O. Atieno
,
Cynthia Wandera
,
Daniel Matemo
,
Jennifer F. Morton
,
Kenneth Ngure
,
John Kinuthia
,
Kenneth K. Mugwanya
·
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.3389/fmed.2025.1552132
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.3389/fmed.2025.1552132
Background Women of childbearing age in sub-Saharan Africa (SSA) face a disproportionately high risk of HIV acquisition. Although oral PrEP has been universally scaled up for individuals at significant risk of HIV, its uptake and sustained use remain suboptimal. Understanding PrEP use decisions offers insights into context-specific barriers and facilitators to its utilization. Methods From September to November 2023, we conducted a qualitative study nested in a larger prospective, open-label clinical trial (FP-Plus). We conducted in-depth interviews (IDIs) with younger women (ages 15–24) and older women (ages ≥25) who declined, delayed, discontinued, or restarted PrEP during the study. IDIs were conducted at two FP clinics by trained Kenyan social scientists and were audio recorded, translated, and transcribed. We analyzed data using inductive and deductive thematic analysis through the lens of the theory of planned behavior (TPB) to explore experiences, beliefs, and rationale among women who made various PrEP decisions. Results We interviewed 64 women, including 40 younger women and 24 older women, all of whom declined, delayed, discontinued, or restarted PrEP (n = 16 women/category). The median age of these women was 24 years (IQR, 23–30). The majority of participants (86%, 55/64) were using family planning methods, primarily injectables (42%, 23/64). PrEP discontinuation or restart was primarily influenced by changes in HIV risk dynamics. Agency and perceived HIV risk were pivotal factors in PrEP use decisions, shaping participants’ ability to practice effective prevention adherence (TPB: perceived behavioral control). Women who declined PrEP cited a lack of autonomy, partner influence, and insufficient information (TPB: social and subjective norms). Low self-efficacy influenced decisions to delay or decline PrEP (TPB: behavioral beliefs and attitudes). In addition, challenges with PrEP pill size, taste, and texture were perceived as barriers to swallowing pills among all groups of women. Participants expressed a preference for alternative PrEP formulations, such as injectable PrEP, due to perceived ease of use, privacy, and potential to support adherence. Conclusion PrEP discontinuation and restart cycles largely reflected changes in HIV risk. Women who decline or delay PrEP may benefit from personalized support to improve their autonomy, recognizing that HIV risk persists during periods of PrEP delay.
Related Topics
Concepts
Pre-exposure prophylaxis
Key (lock)
Family medicine
Medicine
Gynecology
Computer science
Human immunodeficiency virus (HIV)
Men who have sex with men
Computer security
Syphilis
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.3389/fmed.2025.1552132
- https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1552132/pdf
- OA Status
- gold
- References
- 32
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4412159079
All OpenAlex metadata
Raw OpenAlex JSON
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https://openalex.org/W4412159079Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.3389/fmed.2025.1552132Digital Object Identifier
- Title
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“When he is around, I’ll take the PrEP, but when he is not, I will not take PrEP”: key influences on PrEP use decisions among women attending family planning clinics in KenyaWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
-
2025Year of publication
- Publication date
-
2025-07-09Full publication date if available
- Authors
-
Vallery Ogello, Kristin Beima‐Sofie, Sandra Urusaro, Mercy Awuor, Annabell Dollah, Winnie O. Atieno, Cynthia Wandera, Daniel Matemo, Jennifer F. Morton, Kenneth Ngure, John Kinuthia, Kenneth K. MugwanyaList of authors in order
- Landing page
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https://doi.org/10.3389/fmed.2025.1552132Publisher landing page
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https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1552132/pdfDirect link to full text PDF
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YesWhether a free full text is available
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goldOpen access status per OpenAlex
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https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1552132/pdfDirect OA link when available
- Concepts
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Pre-exposure prophylaxis, Key (lock), Family medicine, Medicine, Gynecology, Computer science, Human immunodeficiency virus (HIV), Men who have sex with men, Computer security, SyphilisTop concepts (fields/topics) attached by OpenAlex
- Cited by
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0Total citation count in OpenAlex
- References (count)
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32Number of works referenced by this work
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-
10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.Understanding | 39 |
| abstract_inverted_index.discontinued, | 91, 167 |
| abstract_inverted_index.formulations, | 300 |
| abstract_inverted_index.self-efficacy | 258 |
| abstract_inverted_index.discontinuation | 202, 319 |
| abstract_inverted_index.participants’ | 227 |
| abstract_inverted_index.context-specific | 46 |
| abstract_inverted_index.women/category). | 174 |
| abstract_inverted_index.disproportionately | 11 |
| cited_by_percentile_year | |
| countries_distinct_count | 2 |
| institutions_distinct_count | 12 |
| citation_normalized_percentile.value | 0.33846383 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | False |