31 research outputs found
Impact of the COVID-19 pandemic on routine HIV care and antiretroviral treatment outcomes in Kenya: A nationally representative analysis
Supplemental Material - Prevalence and risk factors of sexually transmitted infections in the setting of a generalized HIV epidemicâa population-based study, western Kenya
Supplemental Material for Prevalence and risk factors of sexually transmitted infections in the setting of a generalized HIV epidemicâa population-based study, western Kenya by Hellen C Awuoche, Rachael H Joseph, Faith Magut, Sammy Khagayi, Fredrick S Odongo, Moses Otieno, Aoko Appolonia, Elijah Odoyo-June, and Daniel O Kwaro in International Journal of STD & AIDS</p
Uptake and continuation of HIV preâexposure prophylaxis among women of reproductive age in two health facilities in Kisumu County, Kenya
Abstract Introduction In 2020, Kenya had 19,000 new HIV infections among women aged 15+ years. Studies have shown subâoptimal oral preâexposure prophylaxis (PrEP) use among subâpopulations of women. We assessed the uptake and continuation of oral PrEP among women 15â49 years in two health facilities in Kisumu County, Kenya. Methods A retrospective cohort of 262 women aged 15â49 years, initiated into oral PrEP between 12 November 2019 and 31 March 2021, was identified from two health facilities in the urban setting of Kisumu County, Kenya. Data on baseline characteristics and oral PrEP continuation at months 1, 3 and 6 were abstracted from patient records and summarized using descriptive statistics. Missing data in the predictor variables were imputed within the joint modelling multiple imputation framework. Using logistic regression, we evaluated factors associated with the discontinuation of oral PrEP at month 1. Results Of the 66,054 women screened, 320 (0.5%) were eligible and 262 (82%) were initiated on oral PrEP. Uptake was higher among women 25â29 years as compared to those 15â24 years (77% vs. 33%). Oral PrEP continuation declined significantly with increasing duration of followâup; 37% at month 1, 21% at month 3 and 12% at month 6 (p<0.05). In the adjusted analysis, women 15â24 years had lower adjusted odds of continuing at month 1 than women â„25 years (adjusted odds ratio [aOR]: 0.41, 95% CI: 0.21â0.82). There was no association between being seroâdiscordant and continuation of oral PrEP at month 1 (aOR; 1.21, 95% CI 0.59â2.50). Women from the subâcounty hospital were more likely to continue at month 1 of followâup compared to women enrolled in the county referral hospital (aOR 5.11; 95% CI 2.24â11.70). Conclusions The low eligibility for oral PrEP observed among women 15â49 years in an urban setting with high HIV prevalence calls for a review of the screening process to validate the sensitivity of the screening tool and its proper application. The low uptake and continuation among adolescent girls and young women underscores the need to identify and address specific patientâ and facilityâlevel barriers affecting different subâpopulations at risk for HIV acquisition
Distribution of HIV infected individuals >15 years old, starting combination antiretroviral therapy, included in the national data warehouse sampling framework and randomly sampled, by COVID-19 exposure status in Kenya (April 2018 to March 2021, N = 7,046).
Distribution of HIV infected individuals >15 years old, starting combination antiretroviral therapy, included in the national data warehouse sampling framework and randomly sampled, by COVID-19 exposure status in Kenya (April 2018 to March 2021, N = 7,046).</p
A comparison of the general eligible and randomly sampled population of HIV infected individuals aged >15 years at the start of combination antiretroviral therapy using data from the national data warehouse (April 01<sup>st</sup> 2018 to March 31<sup>st</sup> 2021, N = 352,322).
A comparison of the general eligible and randomly sampled population of HIV infected individuals aged >15 years at the start of combination antiretroviral therapy using data from the national data warehouse (April 01st 2018 to March 31st 2021, N = 352,322).</p
Overall effect of the COVID-19 pandemic, defined as period after the first documented case when compared to the period prior to the pandemic, on initial virologic non-suppression (VnS) amongst HIV infected individuals aged >15 years using data from the national data warehouse sampling framework in Kenya (April 2018 to March 2021, N = 7,046).
Overall effect of the COVID-19 pandemic, defined as period after the first documented case when compared to the period prior to the pandemic, on initial virologic non-suppression (VnS) amongst HIV infected individuals aged >15 years using data from the national data warehouse sampling framework in Kenya (April 2018 to March 2021, N = 7,046).</p
Flow chart showing distribution of HIV infected individuals starting combination antiretroviral therapy (ART) included in the national data warehouse (NDW) sampling framework and random selection of individuals included in the analysis.
Flow chart showing distribution of HIV infected individuals starting combination antiretroviral therapy (ART) included in the national data warehouse (NDW) sampling framework and random selection of individuals included in the analysis.</p
Fig 3 -
(a) Graph showing time from HIV diagnosis to ART initiation by COVID-19 exposure calendar period when compared to the period prior to the pandemic, and (b) by high infection zone counties, amongst HIV infected individuals >15 years using data from the national data warehouse sampling framework in Kenya (April 01st 2018 to March 31st 2021, N = 7,046).</p
Rollout of ShangRing circumcision with active surveillance for adverse events and monitoring for uptake in Kenya
Introduction: Since 2011, Kenya has been evaluating ShangRing device for use in its voluntary medical male circumcision (VMMC) program according to World Health Organization (WHO) guidelines. Compared to conventional surgical circumcision, the ShangRing procedure is shorter, does not require suturing and gives better cosmetic outcomes. After a pilot evaluation of ShangRing in 2011, Kenya conducted an active surveillance for adverse events associated with its use from 2016â2018 to further assess its safety, uptake and to identify any operational bottlenecks to its widespread use based on data from a larger pool of procedures in routine health care settings. Methods: From December 2017 to August 2018, HIV-negative VMMC clients aged 13 years or older seeking VMMC at six sites across five counties in Kenya were offered ShangRing under injectable local anesthetic as an alternative to conventional surgical circumcision. Providers described both procedures to clients before letting them make a choice. Outcome measures recorded for clients who chose ShangRing included the proportions who were clinically eligible, had successful device placement, experienced adverse events (AEs), or failed to return for device removal. Clients failing to return for follow up were sought through phone calls, text messages or home visits to ensure removal and complete information on adverse events. Results: Out of 3,692 eligible clients 1,079 (29.2%) chose ShangRing; of these, 11 (1.0%) were excluded due to ongoing clinical conditions, 17 (1.6%) underwent conventional surgery due to lack of appropriate device size at the time of the procedure, 97.3% (1051/1079) had ShangRing placement. Uptake of ShangRing varied from 11% to 97% across different sites. There was one severe AE, a failed ShangRing placement (0.1%) managed by conventional wound suturing, plus two moderate AEs (0.2%), post removal wound dehiscence and bleeding, that resolved without sequelae. The overall AE rate was 0.3%. All clients returned for device removal from fifth to eleventh day after placement. Conclusion: ShangRing circumcision is effective and safe in the Kenyan context but its uptake varies widely in different settings. It should be rolled out under programmatic implementation for eligible males to take advantage of its unique benefits and the freedom of choice beyond conventional surgical MMC. Public education on its availability and unique advantages is necessary to optimize its uptake and to actualize the benefit of its inclusion in VMMC programs
Effect of the SARS-CoV-2 pandemic, defined as the period after the first documented case when compared to the period prior to the pandemic, on virologic non-suppression amongst HIV infected individuals >15 years starting combination antiretroviral therapy using data from the national data warehouse sampling framework in Kenya (April 01<sup>st</sup> 2018 to March 31<sup>st</sup> 2021, N = 7,406)<sup>b'*'</sup>.
Effect of the SARS-CoV-2 pandemic, defined as the period after the first documented case when compared to the period prior to the pandemic, on virologic non-suppression amongst HIV infected individuals >15 years starting combination antiretroviral therapy using data from the national data warehouse sampling framework in Kenya (April 01st 2018 to March 31st 2021, N = 7,406)b'*'.</p