High Preference for Injectable Pre-exposure Prophylaxis among Young Women in Kenya

Abstract

Longer acting HIV pre-exposure prophylaxis (PrEP) products are effective options for HIV prevention that require less user-dependence. As programs are preparing to launch delivery of these longer acting products, it is important to understand users' needs and preferences. We conducted a cross-sectional study among women seeking services at 12 family planning clinics in Kisumu, Kenya. Participants were sexually active HIV-negative women ≥15 years, with at least one characteristic that is more common among women who acquire HIV. We assessed PrEP product preferences among PrEP-experienced and inexperienced women. We used descriptive statistics to summarize participants' characteristics, product preferences, and willingness to use different PrEP modalities. We used univariate and multivariate models to assess factors related to preferences for injectable PrEP. A total of 457 participants were enrolled, including 341 with no oral PrEP experience and 116 with recent oral PrEP experience. The median age was 26 [IQR:23-30], 83% were married or cohabiting and 31% reported using injectable contraceptives. Among participants without prior PrEP experience, 74% preferred injectable PrEP, 19% preferred oral PrEP, and 4% preferred the vaginal ring. Among previous oral PrEP users, 82% preferred injectable PrEP, 16% preferred oral PrEP, and only 2% preferred the dapivirine vaginal ring. Only perceived PrEP stigma was significantly associated with injectable PrEP preference (PR: 1.21, 95% CI 1.09, 1.37, P=0.001). Reproductive-age women in Kenya have a strong interest in long-acting injectable PrEP. Product rollout and implementation needs to consider women's preference and devise best approaches to deliver injectable PrEP.

Keywords: Cabotegravir; Dapivirine vaginal ring; HIV prevention; Long-acting PrEP; Preference.