1. Maureen Akolo 1, Kimani J 1,2, Osero J 3, Chitwa M 1, Gichuki R 4 Gelmon L 1,2 1.University of Nairobi 2. University of Manitoba 3. Kenyatta University 4. AMREF Kenya Condom Demonstration and Supply to Index Clients in HIV-sero Discordant Relationship is a Key Component in Positive Health, Dignity and Prevention (PHDP) Compliance in Nairobi, Kenya

2. Background Positive health, dignity, and prevention (PHDP) is a package and an evidence based intervention for PLWHIV-especially sero-discordant couples It focuses on the risk reduction of transmission of the virus to others PHDP compliance is measured by a minimum package of services received that is adherence to care and treatment and any other three PHDP indicators including correct and consistence condom use/supply These interventions were adopted in Kenya in 2013 by the National AIDS and STI Control Program (NASCOP) and the United States Government (USG) affiliates that support HIV prevention programming by the Ministry of Health (MOH).

3. PHDP PACKAGE OF SERVICES 1. Adherence counseling 2. Status disclosure to sexual partner 3. Partner testing 4. Screened for STI 5. Test positive for STI 6. Treated for STI 7. Screened for TB 8. Provided with modern contraceptive 9. Baseline home visit 10. Alcohol consumption counseling 11. Provided with condoms 12. Linked to cPHDP 13. Received minimum package

4. Methods A cross sectional descriptive study that utilized both quantitative and qualitative methods was used 370 index partners in sero discordant relationship were recruited from three clinics within Nairobi County HIV infected clients in discordant relationships who were enrolled in the three clinics and had accessed services within the last 3 months were eligible for the study The clinic’s patient registry was used to contact sequentially those who met the inclusion criteria Standardized data collecting tools were administered Data was cleaned and analyzed using SPSS version 22

5. Demographics Characteristics n% Gender (n=370) Male7319.7 Female29780.3 Age (n=370) (Mean(SD))36.6(8.5) Living with partner (n=370) No17647.6 Yes19452.4 Education level (n=370) None102.7 Primary14138.1 Secondary17246.5 Tertiary4712.7 Source of income (n=370) Employed11631.4 Business19051.4 Other5815.7 None61.6 Salary in Kenyan shillings (n=370) 0-500013837.3 5001-100008623.2

6. Marital status of index partners *Only 2.2% of the clients were able to properly demonstrate how to use a condom

7. Compliance 95% CI for OR CharacteristicsNoYesP-ValueOdds Ratio (OR) Lowerupper Condom use demo No (Ref)16(53.3%)14(46.7%)0.0181 Yes109(32.1%)231(67.9%) 2.421.145.14 Condom supplied No (Ref)5(71.4%)2(28.6%)0.0341 Yes120(33.1%)243(66.9%) 5.060.9726.48 Bivariate analysis of condom demonstration, condom supply and compliance to PHDP practice

8. B IVARIATE ANALYSIS OF CONDOM DEMONSTRATION, CONDOM SUPPLY AND COMPLIANCE TO PHDP PRACTICE A cross tabulation table showed significant relationship between challenges faced by respondents and compliance to PHDP practice. The odd ratio showed that those who accessed condom demonstration complied with PHDP practice two times more than those who did not access condom demonstration Also, the odds ratio indicated that those respondents who accessed condom supply complied with PHDP practice five times more than those who did not access condom supply.

9. Condom supply challenges and PHDP compliance among respondents

10. P ERCEPTION OF, CONDOM PREVENTING HIV VERSES PHDP COMPLIANCE.

11. Conclusions / Recommendations There is significant relationship between challenges in condom supply, condom demonstration and compliance to PHDP practice. Policy makers should encourage condom demonstration and supply in order to promote PHDP compliance among the index partners in sero discordance relationship

12. P HDP TEAM A group of staff offering PHDP services on a team building event.

13. Acknowledgement NASCOP – MOH Kenya CAPT-N Clients in Baba dogo, Pumwani and Majengo clinics Kenyatta University-Dr Justus Osano University of Manitoba-Dr Joshua Kimani CDC- PEPFAR