Publication:

HIV pre-exposure prophylaxis adherence among adolescent girls and young women in Muhoroni, Kisumu County, Kenya

Background This study assessed adherence patterns to oral pre-exposure prophylaxis (PrEP) and associated factors among adolescent girls and young women (AGYW) initiating PrEP in Muhoroni, Kisumu County, Kenya.

Methods A retrospective longitudinal cohort study using routinely collected PrEP data from two high-volume public health facilities in Muhoroni Sub-County, including AGYW aged 15–24 years who initiated oral PrEP in January 2022 and followed for 24 months. Adherence was defined as continuous use without missed monthly visits, with appropriate discontinuation considered adherent. Descriptive statistics summarized characteristics and adherence patterns, while associations were assessed using modified Poisson regression with generalized estimating equations (GEE) accounting for within-individual correlation.

Results PrEP adherence was high, with 82.2% (263/320) of participants’ adherent. In bivariate analysis, adherence was significantly associated with marital status (p=0.003), education level (p=0.046), population type (p=0.021), injection drug use (p=0.042), shared syringe use (p=0.032), and STI status (p=0.021), but not with age or school attendance (p>0.05). In unadjusted analyses, higher education was associated with increased adherence (secondary: PR=1.22, 95% CI: 1.00–1.50; tertiary: PR=1.31, 95% CI: 1.07–1.61). In adjusted models, tertiary education remained significantly associated with adherence (aPR=1.30, 95% CI: 1.05–1.60). Shared syringe use was associated with higher adherence (aPR=1.40, 95% CI: 1.00–1.96). Other factors were not statistically significant after adjustment.

Conclusions PrEP adherence among AGYW was high. Education was a key determinant; however, behavioral factors highlight the need for targeted, context-specific interventions.