Innovative Methods in Delivering Pre-Exposure Prophylaxes Services for Adolescent Girls and Young Women: Outcomes from the Consumer Demand – Driven Project in Nairobi County, Kenya

Abstract

Background: There is high HIV prevalence among adolescent girls and young women (AGYW) aged 15-24years, accounting for 21% of 88,000 new HIV infections in Kenya. With funding from the US Department of State (DOS), BHESP implemented a two-year project to deliver Pre-Exposure Prophylaxis (PrEP) for AGYW in Nairobi. The objective of the evaluation was to establish effectiveness of the innovation in raising demand and expanding access to PrEP. Methods: A mixed-method study design was applied, utilising quantitative and qualitative data. A random sample of 213 AGYW took part in a satisfaction survey, while semi-structured focus group discussions (FGDs) were carried out with AGYW and peer educators. Review of program secondary data was also done. Quantitative data was analysed using MS Excel, while thematic analysis applied for qualitative data. Results: BHESP reached 30,455 community members with HIV and PrEP information, majority of whom were females (67.2%). HIV counselling and testing was done for 29,241community members, comprising 17,834 (70.0%) AGYW. Of these, 5126persons were newly enrolled in PrEP, including 4957 (97.8%) AGYW. Barriers to access and continuation of services were side effects; 110 (55.6%) and time constraints; 102 51.8%. Enabling factors were reminders calls from service providers; 147 (72%) and risk reduction; 147 (72%). Satisfaction levels was high, with 208 (98.6%) of expressing overall satisfaction, specifically in enrolment process; 192(90.3%), service delivery; 194 (90.9%), and quality of services; 198 (92.8%). Conclusion: The innovation was successful in raising awareness and enhancing uptake of PrEP. Profiling and follow-up of AGYW are critical in defining and tracking continuation. We recommend further insights gathering on factors affecting PrEP continuation and the most effective ways of involving males to catalyse overall success.