title: Repeat Use of Post-exposure Prophylaxis for HIV Among Nairobi-Based Female Sex Workers Following Sexual Exposure.
abstract: As ART-based prevention becomes available, effectively targeting these interventions to key populations such as female sex workers (FSW) will be critical. In this study we analyze patterns of repeated post-exposure prophylaxis (PEP) access in the context of a large FSW program in Nairobi. During close to 6000 person-years of follow-up, 20 % of participants (n = 1119) requested PEP at least once and 3.7 % requested PEP more than once. Repeat PEP users were younger, had a higher casual partner volume, and were more likely to use condoms with casual and regular partners, have a regular partner, and test for HIV prior to enrolment. Barriers to PEP included stigma, side effects, and lack of knowledge, suggesting repeated promotion may be required for higher rates of uptake. A small subset of FSW, potentially those with heightened risk perception, showed a higher frequency of PEP use; these individuals may be most amenable to rollout of pre-exposure prophylaxis.
authors.affiliation: Kenya AIDS Control Project, Department of Medical Microbiology, University of Nairobi, PO Box 69555-00400, Nairobi, Kenya. PIzulla@gmail.com.
authors.forename: Preston
authors.initials: P
authors.lastname: Izulla
authors.affiliation: Kenya AIDS Control Project, Department of Medical Microbiology, University of Nairobi, PO Box 69555-00400, Nairobi, Kenya.|Department of Medicine, University of Toronto, Toronto, Canada.|Centre for the AIDS Program of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Lyle R
authors.initials: LR
authors.lastname: McKinnon
authors.affiliation: Kenya AIDS Control Project, Department of Medical Microbiology, University of Nairobi, PO Box 69555-00400, Nairobi, Kenya.
authors.forename: Julius
authors.initials: J
authors.lastname: Munyao
authors.affiliation: Kenya AIDS Control Project, Department of Medical Microbiology, University of Nairobi, PO Box 69555-00400, Nairobi, Kenya.
authors.forename: Naomi
authors.initials: N
authors.lastname: Ireri
authors.affiliation: Department of Community Medicine, United Arab Emirates University, Al Ain, United Arab Emirates.|Department of Medical Microbiology, University of Manitoba, Winnipeg, Canada.
authors.forename: Nico
authors.initials: N
authors.lastname: Nagelkerke
authors.affiliation: Kenya AIDS Control Project, Department of Medical Microbiology, University of Nairobi, PO Box 69555-00400, Nairobi, Kenya.
authors.forename: Gloria
authors.initials: G
authors.lastname: Gakii
authors.affiliation: Kenya AIDS Control Project, Department of Medical Microbiology, University of Nairobi, PO Box 69555-00400, Nairobi, Kenya.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Gelmon
authors.affiliation: School of Public Health, Moi University, Eldoret, Kenya.
authors.forename: Mabel
authors.initials: M
authors.lastname: Nangami
authors.affiliation: Kenya AIDS Control Project, Department of Medical Microbiology, University of Nairobi, PO Box 69555-00400, Nairobi, Kenya.|Department of Medicine, University of Toronto, Toronto, Canada.
authors.forename: Rupert
authors.initials: R
authors.lastname: Kaul
authors.affiliation: Kenya AIDS Control Project, Department of Medical Microbiology, University of Nairobi, PO Box 69555-00400, Nairobi, Kenya.|Department of Medical Microbiology, University of Manitoba, Winnipeg, Canada.
authors.forename: Joshua
authors.initials: J
authors.lastname: Kimani
mesh_terms: D000328:Adult; D000367:Age Factors; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D017280:Condoms / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007630:Kenya; D008297:Male; D056990:Post-Exposure Prophylaxis; D060386:Sex Workers / Q000523:psychology*; D012725:Sexual Behavior; D012747:Sexual Partners; D057545:Social Stigma; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents
keywords: FSW; HIV prevention; PEP; PrEP; Risk perception