Table 2.
Frequency of Behavioral HIV Risk Factors, Psychosocial Characteristics, and PrEP Attitudes Among AGYW Seeking Routine FP Services in Western Kenya Who Initiated or Declined PrEP (n = 470)
| Characteristic | Initiated PrEP todaya |
PR (95% CI)a | p | |
|---|---|---|---|---|
| Yes (n = 20) n (%) | No (n = 450) n (%) | |||
| Behavioral HIV risk factors | ||||
| Has partner of unknown/positive HIV status | 11 (55.0) | 68 (15.1) | 6.05 (1.83–20.01) | 0.003* |
| ≥4 Total lifetime sexual partners | 5 (25.0) | 52 (11.6) | 2.16 (0.73–6.43) | 0.165 |
| Had condomless sexb | 18 (90.0) | 335 (74.4) | 1.21 (1.02–1.44) | 0.033* |
| Engaged in transactional sexb | 0 (0.0) | 22 (4.9) | — | — |
| Forced to have sex against their willb | 1 (5.0) | 23 (5.1) | 0.98 (0.06–15.06) | 0.987 |
| Experienced intimate partner violencec (n = 388) | 2 (11.8) | 9 (2.4) | 4.85 (1.03–22.73) | 0.045* |
| High self-perceived HIV riskd | 17 (85.0) | 47 (10.4) | 1.68 (1.41–1.99) | <0.001* |
| Partner age difference ≥10 years (n = 358) | 6 (40.0) | 27 (7.9) | 6.57 (2.35–18.370 | <0.001* |
| HIV risk score factors (Balkus et al.e) | ||||
| Unmarried/not living with partner | 5 (25.0) | 205 (45.6) | 0.55 (0.31–0.98) | 0.041* |
| Alcohol use (past 30 days) | 6 (30.0) | 62 (13.8) | 2.18 (1.43–3.33) | <0.001* |
| Partner does not provide financial support | 1 (5.0) | 9 (2.0) | 2.50 (0.56–11.23) | 0.232 |
| Primary partner has other partners | 15 (75.0) | 146 (32.4) | 2.31 (1.83–2.92) | <0.001* |
| High behavioral HIV riske | 8 (40.0) | 103 (22.9) | 1.75 (1.24–2.46) | 0.001* |
| Psychosocial characteristics | ||||
| Low social support | 14 (70.0) | 156 (34.7) | 2.01 (1.63–2.48) | <0.001* |
| Depressive symptoms | 9 (60.0) | 40 (11.2) | 5.36 (2.62–10.95) | <0.001* |
| High self-efficacy to take daily medicationf | 20 (100.0) | 284 (63.7) | 1.57 (1.17–2.12) | 0.003* |
| PrEP attitudes and beliefs | ||||
| Heard of PrEP before today | 12 (60.0) | 404 (89.8) | 0.67 (0.43–1.04) | 0.074 |
| Knows someone on PrEP | 3 (15.0) | 91 (20.2) | 0.74 (0.09–6.43) | 0.786 |
| Thinks PrEP is for people who are promiscuous | 0 (0.0) | 7 (1.6) | — | — |
| Thinks PrEP will cause more risky sex | 2 (10.0) | 27 (6.0) | 1.67 (0.34–8.19) | 0.530 |
| Thinks PrEP is only for sex workers or people with HIV-infected partner(s) | 0 (0.0) | 3 (0.7) | — | — |
Tabulations reported for PrEP initiation today (yes/no) and other characteristics are reported as column percentages. PRs were estimated using Poisson regression, clustered by facility.
Within the last 6 months.
We evaluated intimate partner violence using the 4-item HITS Scale, defining intimate partner violence as scores of 10 and above (IPV: HITS score ≥10 = Yes, HITS score <10 = No).
We evaluated self-perceived HIV risk by asking “What is your gut feeling about how likely you are to get infected with HIV?” with possible responses of “very likely,” “somewhat likely,” “very unlikely,” or “extremely unlikely.” (high self-perceived HIV risk: very/somewhat likely = Yes, extremely/very unlikely = No).
We evaluated behavioral HIV risk using the Balkus et al. HIV risk scoring: age <25 = 1, married = 2, any alcohol = 1, partner provides financial support = 1, and partner has other partners: yes = 2 and do not know = 2. Scores of ≥5 correspond to 5–15 incident HIV cases per 100 person-years in cohorts of African women; risk scores of ≤4 correspond to <5 incident HIV cases per 100 person-years. (high HIV risk: HIV risk score ≥5 = Yes, HIV risk score <5 = No).
We evaluated self-efficacy to take a daily oral medication by asking participants to rank on a 0–10 scale (0 = cannot do it at all, 10 = completely certain can do it) their response to the question: “How confident are you that you can integrate a daily medication into your daily routine?”
Significance level ≤5%.
AGYW, adolescent girls and young women; CI, confidence interval; FP, family planning; HITS, Hurt, Insult, Threaten, and Scream; PR, prevalence ratio; PrEP, pre-exposure prophylaxis.