title: Willingness of Kenyan HIV-1 serodiscordant couples to use antiretroviral-based HIV-1 prevention strategies.
abstract: BACKGROUND
  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.
authors.affiliation: Department of Epidemiology, University of Washington, 325 Ninth Avenue, Box 359927, Seattle, WA 98104, USA. rheffron@uw.edu
authors.forename: Renee
authors.initials: R
authors.lastname: Heffron
authors.forename: Kenneth
authors.initials: K
authors.lastname: Ngure
authors.forename: Nelly
authors.initials: N
authors.lastname: Mugo
authors.forename: Connie
authors.initials: C
authors.lastname: Celum
authors.forename: Ann
authors.initials: A
authors.lastname: Kurth
authors.forename: Kathryn
authors.initials: K
authors.lastname: Curran
authors.forename: Jared M
authors.initials: JM
authors.lastname: Baeten
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000008:administration & dosage*; D018890:Chemoprevention / Q000379:methods*; D003430:Cross-Sectional Studies; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D005191:Family Characteristics; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission* / Q000821:virology; D015497:HIV-1 / Q000302:isolation & purification; D006801:Humans; D007630:Kenya; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*
chemical_list: D044966:Anti-Retroviral Agents