1. IMPLEMETNATION OF PrEP IN SRH SETTINGS (OR CLIMBING A MOUNTAIN)
Elizabeth Anne Bukusi
Chief Research Officer
Kenya Medical Institute
Research Professor , University of Washington

2. COI Funding for implementation research for PrEP among young women by
USAID
NIH

3. Kisumu City

5. Source: Kenya HIV County Profiles 2014 National AIDS Control Council
Situation Analysis
INDICATOR
KISUMU
Total Population (2013)
1,059,053
HIV adult prevalence (overall)
19.3%
HIV Prevalence among women
20.6%
HIV Prevalence among men
17.8%
Number of adults living with HIV
118,500
Number of children living with HIV
16,326
Total number of people living with HIV
134,826
% of people never tested for HIV by 2009
73%
% of HIV Positive pregnant women who do not deliver in a health facility
55%
New adult HIV infections annually
County
10,346
National estimate
88,620
Source: Kenya HIV County Profiles 2014
National AIDS Control Council

6. The Kenyan HIV Epidemic
National AIDS Control Council

7. HIV prevalence among 15-24 year olds in Kenya
The prevalence among young women declined from 5.9% in 2003 to 3% in 2012 while the prevalence among young men remained relatively stable between % during the same period. Prevalence was attributable to new infections as opposed to ART treatment initiation (NACC 2014)

8. THE TARGET POPULATION

11. LEADERSHIP

14. HEALTH SYSTEMS ENGAGMENT

17. COMMUNITY

18. Potential Barriers
Time off work /school may be limited
Fear of stigma associated with disease under study
Transportation cost
Household responsibilities-taking care of children, older family members
School

20. MALE ENGAGEMENT

26. Retention strategies Appropriate and clear PrEP messaging
Friendly clinic environment
Fast tracking and short waiting time
Friendly and flexible staff
Wi-Fi
Integrating other clinic services to save on time
Phone call reminders
Support group
Continuous engagement via text and social media

28. The POWER STUDY – Kisumu Kenya -2018
Age 16-25
Able and willing to provide written informed consent
Recently sexually active (defined as having had vaginal intercourse at least once in the previous three months)
HIV uninfected based on negative HIV rapid tests, on the date of enrollment

30. STI PREVALENCE

31. Challenges Mobilization
Client- stigma, pill burden, disclosure, PrEP and condom use
Community- Myths and misconceptions about PrEP

32. Challenges Integration Long waiting time- in other services
Space- shared; limited privacy and confidentiality
Nursing staff- negative attitude. Additional work, staff rotation
Laboratory- staff attitude
Pharmacy- staff rotation

34. Success Numbers enrolled and referring friends and networks
We are penetrating the community and increasing PrEP awareness
Some initial refusers have taken up PrEP

36. It will not be easy, but it will be worth it