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Truong HHM, Heylen E, Kadede K, Amboka S, Otieno B, Odhiambo H, Odeny D, Hewa M, Opiyo M, Opondo F, Ogolla D, Guzé MA, Miller LE, Bukusi EA, Cohen CR. Brief Report: HIV Pre-Exposure Prophylaxis Awareness and Use Among Adolescents in Kenya. J Acquir Immune Defic Syndr 2024; 95:133-137. [PMID: 37988676 PMCID: PMC10872474 DOI: 10.1097/qai.0000000000003338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 07/24/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND HIV pre-exposure prophylaxis (PrEP) is an effective prevention tool; however, use among adolescents is thought to be low. To determine the unmet need and opportunity to expand use, we assessed awareness, prior use, and willingness to take PrEP among Kenyan adolescents. METHODS The Maneno Yetu study recruited a community-based sample of adolescents aged 15-19 years (N = 3061) in Kisumu for a survey using respondent-driven sampling. RESULTS Overall, 50% of adolescents had heard of PrEP and 2% had used PrEP. Girls were more likely than boys to have heard of PrEP (53.4% vs. 45.1%; P < 0.001) and used PrEP (3.6% vs. 0.3%; P < 0.001). Among participants, 14% engaged in transactional sex and 21% experienced forced sexual contact. PrEP use was higher among adolescents who engaged in transactional sex (4.8% vs. 0.6%; P < 0.001) and experienced forced sexual contact (2.7% vs. 0.7%; P < 0.001) compared with those who did not. Among adolescents with no prior use, 53% were willing to consider using PrEP, although girls were less willing than boys (49.7% vs. 55.9%; P = 0.001). CONCLUSIONS PrEP is an important prevention tool, especially for adolescents whose circumstances potentially expose them to HIV-positive or unknown status sexual partners, yet remains underused, particularly in resource-limited settings. Although many expressed willingness to use PrEP, low awareness and use highlight the need to expand HIV prevention education and services tailored for adolescents. Our finding that boys were more willing to use PrEP suggests campaigns should also be designed to reach male youth to narrow the gender gap and expand uptake in the adolescent population.
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Truong HHM, Guzé MA, Kadede K, Amboka S, Otieno B, Odhiambo H, Odeny D, Hewa M, Opiyo M, Opondo F, Fatch R, Ogolla D, Miller LE, Bushman D, Auerswald C, Bukusi EA, Cohen CR. HIV Infection Among Adolescents Residing in Urban Informal Settlements of Kenya. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2023; 35:225-234. [PMID: 37410374 PMCID: PMC10624479 DOI: 10.1521/aeap.2023.35.3.225] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
Adolescents comprise approximately 15% of new HIV infections in Kenya. Impoverished living conditions in informal settlements place residents at high risk for HIV infection. We assessed factors associated with HIV infection among adolescents residing in urban informal settlements in Kisumu. We recruited 3,061 adolescent boys and girls aged 15-19. HIV prevalence was 2.5% overall, all newly identified cases were among girls and infection was positively associated with not completing a secondary education (p < .001). Girls who had ever been pregnant (p < .001) or out-of-school without completing a secondary education (p < .001) were more likely to be HIV-positive. Our findings of higher HIV prevalence among adolescent girls who had been pregnant or did not complete secondary school highlight the need to facilitate access to HIV testing, HIV pre-exposure prophylaxis, and sexual and reproductive health services as components of a comprehensive prevention strategy to decrease HIV infections in this priority population.
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Affiliation(s)
| | | | | | - Sayo Amboka
- Kenya Medical Research Institute, Kisumu, Kenya
| | | | | | | | - Marion Hewa
- Kenya Medical Research Institute, Kisumu, Kenya
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Truong HHM, Fatch R, Ogolla D, Otieno B, Amboka S, Kadede K, Cohen CR, Bukusi EA, Guzé MA. Respondent-driven sampling to recruit adolescents in Kenya. Ann Epidemiol 2023; 78:68-73. [PMID: 36509343 PMCID: PMC10789922 DOI: 10.1016/j.annepidem.2022.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 10/21/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE Respondent-driven sampling (RDS) uses long-chain referral whereby members of the target population recruit other members. We describe the use of RDS for a mixed-methods sexual and reproductive health (SRH) study in Kisumu, Kenya. METHODS Initial seeds for the cross-sectional surveys were selected from adolescents aged 15-19 residing in urban informal settlements. Participants were provided up to five referral coupons to distribute. RESULTS Across four communities, 18 seeds were selected, 13,489 coupons distributed, and 3381 adolescents referred, yielding a 25% coupon return rate. We enrolled 3061 participants for a 23% survey rate. Median referral lag time was three days (IQR 1, 7). Demographic characteristics reached equilibrium between recruitment waves 5 to 8 in three communities, and waves 7 to 15 in the fourth. CONCLUSIONS Our study demonstrated that RDS is a feasible and efficient approach for recruiting a large sample of adolescents. Though our research focused on SRH, many adolescents residing in the impoverished urban environments where our study was implemented also experience food insecurity, housing instability and violence. RDS can therefore be a valuable recruitment approach for future studies to reach vulnerable adolescents and design interventions that address the variety of health-related challenges that affect this underserved population.
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Affiliation(s)
- Hong-Ha M Truong
- University of California San Francisco, San Francisco, California, USA.
| | - Robin Fatch
- University of California San Francisco, San Francisco, California, USA
| | | | | | - Sayo Amboka
- Kenya Medical Research Institute, Kisumu, Kenya
| | | | - Craig R Cohen
- University of California San Francisco, San Francisco, California, USA
| | | | - Mary A Guzé
- University of California San Francisco, San Francisco, California, USA
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Bossonario PA, Ferreira MRL, Andrade RLDP, de Sousa KDL, Bonfim RO, Saita NM, Monroe AA. Risk factors for HIV infection among adolescents and the youth: a systematic review. Rev Lat Am Enfermagem 2022; 30:e3697. [PMID: 36197391 PMCID: PMC9647917 DOI: 10.1590/1518-8345.6264.3696] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE to identify and analyze HIV infection risk factors among adolescents and the youth. METHOD this is a systematic review whose guide question is: what are the risk factors for HIV infection among adolescents and the youth?" In total, five databases and Google Scholar were searched in December 2021 and the found publications between 2012-2022 were filtered without language restriction. Studies were selected by two independent reviewers. The included materials were subjected to methodological quality evaluation and narrative synthesis. RESULTS overall, we included seven studies out of the 26,191 retrieved. All studies were conducted in Africa. We found that the female gender, older age, low schooling, Black ethnicity, multiple sexual partners, inconsistent use of condoms, alcohol consumption, and early sexual onset constituted risk factors for HIV infection in adolescents and the youth. CONCLUSION understanding risk factors underscores the provision of health policies and intervention strategies to strengthen the responsiveness of health services and nursing teams' care to reduce HIV transmission among adolescents and the youth. UNLABELLED (1) Our knowledge synthesis contributes to the care provided in health services. (2) The main factors for HIV are related to risk behaviors. (3) Our results point to the purpose of health policies to prevent HIV. (4) IWe assessed the importance of different social actors and management bodies to cope with HIV. (5) This study strengthens the role of nursing in preventing HIV transmission.
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Affiliation(s)
- Pedro Augusto Bossonario
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brasil
| | - Melisane Regina Lima Ferreira
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brasil
| | - Rubia Laine de Paula Andrade
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brasil
| | - Keila Diane Lima de Sousa
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brasil
| | - Rafaele Oliveira Bonfim
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brasil
| | - Nanci Michele Saita
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brasil
| | - Aline Aparecida Monroe
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brasil
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Bossonario PA, Ferreira MRL, Andrade RLDP, Sousa KDLD, Bonfim RO, Saita NM, Monroe AA. Factores de riesgo de infección por VIH entre adolescentes y jóvenes: revisión sistemática. Rev Lat Am Enfermagem 2022. [DOI: 10.1590/1518-8345.6264.3695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Resumen Objetivo: identificar y analizar los factores de riesgo de infección por VIH entre adolescentes y jóvenes. Método: se trata de una revisión sistemática que tuvo como pregunta orientadora: “¿Cuáles son los factores de riesgo a la infección por el VIH entre adolescentes y jóvenes?”. Las búsquedas en cinco bases de datos y en Google Scholar ocurrieron en diciembre de 2021, teniendo como filtro de publicaciones entre 2012-2022 sin limitación de idiomas. Las publicaciones fueron seleccionadas por dos revisores independientes. Los materiales incluidos fueron sometidos a la evaluación de la calidad metodológica y a una síntesis narrativa. Resultados: se recuperaron 26.191 materiales, siendo siete artículos incluidos. Todos los estudios se realizaron en África. Se identificó que el sexo femenino, la mayor edad de los jóvenes, baja escolaridad, personas negras, múltiples parejas sexuales, el uso inconsistente de preservativos, consumo de alcohol y el inicio temprano de las relaciones sexuales eran factores de riesgo de infección por el VIH en adolescentes y jóvenes. Conclusión: la comprensión de los factores de riesgo fundamenta la proposición de políticas de salud y estrategias de intervención con la finalidad de fortalecer la capacidad de respuesta de los servicios de salud y el cuidado del equipo de enfermería para la disminución de la transmisión del VIH entre adolescentes y jóvenes.
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Bossonario PA, Ferreira MRL, Andrade RLDP, Sousa KDLD, Bonfim RO, Saita NM, Monroe AA. Fatores de risco à infecção pelo HIV entre adolescentes e jovens: revisão sistemática. Rev Lat Am Enfermagem 2022; 30:e3697. [DOI: 10.1590/1518-8345.6264.3697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 06/20/2022] [Indexed: 12/23/2022] Open
Abstract
Resumo Objetivo: identificar e analisar os fatores de risco à infecção pelo HIV entre adolescentes e jovens. Método: trata-se de uma revisão sistemática que teve como questão norteadora: quais são os fatores de risco à infecção pelo HIV entre adolescentes e jovens?”. As buscas em cinco bases de dados e no Google Scholar ocorreram em dezembro de 2021, tendo como filtro publicações entre 2012-2022 sem limitação de idiomas. As publicações foram selecionadas por dois revisores independentes. Os materiais incluídos foram submetidos à avaliação da qualidade metodológica e a uma síntese narrativa. Resultados: recuperou-se 26.191 materiais, sendo sete artigos incluídos. Todos os estudos foram conduzidos na África. Identificou-se que o sexo feminino, a maior idade dos jovens, baixa escolaridade, pessoas negras, múltiplas parcerias sexuais, uso inconsistente de preservativos, consumo de álcool e início sexual precoce constituíram fatores de risco para a infecção pelo HIV em adolescentes e jovens. Conclusão: a compreensão dos fatores de risco alicerça a propositura de políticas de saúde e estratégias de intervenção com a finalidade de fortalecer a capacidade de resposta dos serviços de saúde e o cuidado da equipe de enfermagem para a diminuição da transmissão do HIV entre adolescentes e jovens.
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