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A pilot study of Pre-Exposure Prophylaxis (PrEP) to evaluate safety, acceptability, and adherence in at-risk populations in Uganda and Kenya

Study Status:
Uganda: HIV-discordant couples; Kenya: Healthy HIV-uninfected males and females age 18-49 at risk for HIV

Study Summary:
This study used qualitative methods to explore experiences of men who have sex with men and female sex workers in Nairobi and Mtwapa, Kenya and HIV-discordant couples in Entebbe, Uganda who used oral pre-exposure prophylaxis (PrEP) for HIV prevention as part of a four-month trial of safety, acceptability and adherence.  Seventy-two participants took part in a randomized, placebo-controlled, blinded trial that compared daily and intermittent dosage of PrEP (emtricitabine/tenofovir), and underwent qualitative assessments after completing participation.  In Kenya, while acceptability of PrEP was high, adherence was challenged by complexities of daily life, in particular post-coital dosing adherence suffered from alcohol use around time of sex, mobile populations, and transactional sex work.  Based on this, PrEP users need culturally appropriate and consistent counseling to ensure adherence.  See poster with Kenya results presented at IAS 2011 here 
Uganda results are forthcoming.