Willingness of Kenyan HIV-1 serodiscordant couples to use antiretroviral-based HIV-1 prevention strategies

Renee Heffron, Kenneth Ngure, Nelly Mugo, Connie Celum, Ann Kurth, Kathryn Curran, Jared M. Baeten

Research output: Contribution to journalArticle

Abstract

Introduction: Antiretroviral treatment (ART) and pre-exposure prophylaxis (PrEP) have demonstrated efficacy as new human immunodeficiency virus-1 (HIV-1) prevention approaches for HIV-1 serodiscordant couples. Methods: Among Kenyan HIV-1 serodiscordant heterosexual couples participating in a clinical trial of PrEP, we conducted a cross-sectional study and used descriptive statistical methods to explore couples' willingness to use antiretrovirals for HIV-1 prevention. The study was conducted before July 2011, when studies among heterosexual populations reported that ART and PrEP reduced HIV-1 risk. Results: For 181 couples in which the HIV-1-infected partner had a CD4 count 350 cells per microliter and had not yet initiated ART (and thus did not qualify for ART under Kenyan guidelines), 60.2% of HIV-1 infected partners (69.4% of men and 57.9% of women) were willing to use early ART (at CD4 350 cells per microliter) for HIV-1 prevention. Among HIV-1 uninfected partners, 92.7% (93.8% of men and 86.1% of women) reported willingness to use PrEP. When given a hypothetical choice of early ART or PrEP for HIV-1 prevention, 52.5% of HIV-1-infected participants would prefer to initiate ART early and 56.9% of HIV-1-uninfected participants would prefer to use PrEP. Conclusions: Nearly 40% of Kenyan HIV-1-infected individuals in known HIV-1 serodiscordant partnerships reported reservations about early ART initiation for HIV-1 prevention. PrEP interest in this PrEP-experienced population was high. Strategies to achieve high uptake and sustained adherence to ART and PrEP for HIV-1 prevention in HIV-1 serodiscordant couples will require responding to couples' preferences for prevention strategies.

Original languageEnglish (US)
Pages (from-to)116-119
Number of pages4
JournalJournal of Acquired Immune Deficiency Syndromes
Volume61
Issue number1
DOIs
StatePublished - Sep 1 2012

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HIV-1
Therapeutics
Heterosexuality
Pre-Exposure Prophylaxis
CD4 Lymphocyte Count
Population
Cross-Sectional Studies

Keywords

  • Africa
  • antiretrovirals
  • couples
  • HIV prevention
  • pre-exposure prophylaxis

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

Cite this

Willingness of Kenyan HIV-1 serodiscordant couples to use antiretroviral-based HIV-1 prevention strategies. / Heffron, Renee; Ngure, Kenneth; Mugo, Nelly; Celum, Connie; Kurth, Ann; Curran, Kathryn; Baeten, Jared M.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 61, No. 1, 01.09.2012, p. 116-119.

Research output: Contribution to journalArticle

Heffron, Renee ; Ngure, Kenneth ; Mugo, Nelly ; Celum, Connie ; Kurth, Ann ; Curran, Kathryn ; Baeten, Jared M. / Willingness of Kenyan HIV-1 serodiscordant couples to use antiretroviral-based HIV-1 prevention strategies. In: Journal of Acquired Immune Deficiency Syndromes. 2012 ; Vol. 61, No. 1. pp. 116-119.
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abstract = "Introduction: Antiretroviral treatment (ART) and pre-exposure prophylaxis (PrEP) have demonstrated efficacy as new human immunodeficiency virus-1 (HIV-1) prevention approaches for HIV-1 serodiscordant couples. Methods: Among Kenyan HIV-1 serodiscordant heterosexual couples participating in a clinical trial of PrEP, we conducted a cross-sectional study and used descriptive statistical methods to explore couples' willingness to use antiretrovirals for HIV-1 prevention. The study was conducted before July 2011, when studies among heterosexual populations reported that ART and PrEP reduced HIV-1 risk. Results: For 181 couples in which the HIV-1-infected partner had a CD4 count 350 cells per microliter and had not yet initiated ART (and thus did not qualify for ART under Kenyan guidelines), 60.2{\%} of HIV-1 infected partners (69.4{\%} of men and 57.9{\%} of women) were willing to use early ART (at CD4 350 cells per microliter) for HIV-1 prevention. Among HIV-1 uninfected partners, 92.7{\%} (93.8{\%} of men and 86.1{\%} of women) reported willingness to use PrEP. When given a hypothetical choice of early ART or PrEP for HIV-1 prevention, 52.5{\%} of HIV-1-infected participants would prefer to initiate ART early and 56.9{\%} of HIV-1-uninfected participants would prefer to use PrEP. Conclusions: Nearly 40{\%} of Kenyan HIV-1-infected individuals in known HIV-1 serodiscordant partnerships reported reservations about early ART initiation for HIV-1 prevention. PrEP interest in this PrEP-experienced population was high. Strategies to achieve high uptake and sustained adherence to ART and PrEP for HIV-1 prevention in HIV-1 serodiscordant couples will require responding to couples' preferences for prevention strategies.",
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AU - Kurth, Ann

AU - Curran, Kathryn

AU - Baeten, Jared M.

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