HIV pre-exposure prophylaxis uptake and associated factors among HIV serodiscordant heterosexual couples in Nairobi city county, Kenya

Document Type

Article

Department

Population Health (East Africa)

Abstract

HIV antiretroviral drugs used as pre-exposure prophylaxis (PrEP) are effective for HIV prevention. This study evaluated determinants of PrEP uptake among HIV-negative spouses in HIV-serodiscordant heterosexual relationships in Nairobi City County, Kenya. Of the 424 participants, 114 reported current PrEP use, resulting in a PrEP uptake of 27% (23–31%). The top reason for current PrEP use was to achieve pregnancy (n = 69; 61%). Of the 424 participants, 209 (49%) had never used PrEP, and the leading reasons for never using PrEP were lack of PrEP information (38%) and self-perceived low risk for HIV (36%). Factors associated with decreased likelihood of PrEP use included: low level of education (p = 0.026), self-perception of being at low-to-no risk for HIV (p = 0.021), lack of desire for more children (p = 0.005) and lack of knowledge that PrEP is offered free (p = 0.004). Female sex (aOR = 2.3; 95% CI: 1.4–4.0) and lack of condom use (aOR = 2.5; 95% CI: 1.4–4.5) were associated with increased odds of taking PrEP. Uptake of PrEP among HIV-serodiscordant couples in Nairobi City County was low, and PrEP use was driven by desire to fulfill pregnancy intentions. Aggressive educational campaigns to address self-HIV-risk perceptions and increase PrEP knowledge are necessary for increased PrEP demand.

Publication (Name of Journal)

AIDS Care

DOI

https://doi.org/10.1080/09540121.2025.2480156

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

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