Brief report: Reduced HIV risk-taking and low HIV incidence after enrolment and risk-reduction counselling in a sexually transmitted disease prevention trial in Nairobi, Kenya

Authors

Rupert Kaul, University of Nairobi
Joshua Kimani, University of Nairobi
Nico J. Nagelkerke, University of Nairobi
Karoline Fonck, University of Nairobi
Florence Keli, University of Nairobi
Kelly S. MacDonald, University of Nairobi
Allan R. Ronald, University of Nairobi
Francis A. Plummer, University of Nairobi
Job J. Bwayo, University of Nairobi
Elizabeth N. Ngugi, University of Nairobi
Marleen Temmerman, Aga Khan UniversityFollow
Stephen Moses, University of Nairobi

Document Type

Article

Department

Obstetrics and Gynaecology (East Africa)

Abstract

There is an urgent need in sub-Saharan Africa to develop more effective methods of HIV prevention, including improved strategies of sexually transmitted infection (STI) prevention or an HIV vaccine. The efficacy of these strategies may be tested through clinical trials within cohorts at high risk for STI and HIV, such as female commercial sex workers. For ethical reasons, standard HIV prevention services, including access to free condoms, risk-reduction counseling, and STI therapy, will generally be offered to all study subjects. Because study subjects would often not otherwise have access to these prevention services, it is possible that enrollment in such clinical trials will itself reduce incidence rates of STI and HIV below expected levels, reducing the power to test the efficacy of the randomized intervention. We show that the provision of standard HIV prevention services as part of a randomized STI/HIV prevention trial is temporally associated with a dramatic reduction in sexual risk-taking, and that this reduction is directly associated with reduced STI incidence. This finding should be considered in the design of clinical trials with an endpoint of HIV incidence, in particular HIV preventive vaccine trials.

Comments

This work was published before the author joined Aga Khan University.

Publication (Name of Journal)

Journal of acquired immune deficiency syndromes

Recommended Citation

Kaul, R., Kimani, J., Nagelkerke, N. J., Fonck, K., Keli, F., MacDonald, K. S., Ronald, A. R., Plummer, F. A., Bwayo, J. J., Ngugi, E. N., Temmerman, M., Moses, S. (2002). Brief report: Reduced HIV risk-taking and low HIV incidence after enrolment and risk-reduction counselling in a sexually transmitted disease prevention trial in Nairobi, Kenya. Journal of acquired immune deficiency syndromes, 30(1), 69-72.
Available at: https://ecommons.aku.edu/eastafrica_fhs_mc_obstet_gynaecol/439