Determinants of Pre-exposure Prophylaxis (Prep) Services Uptake: the Case of Ahero County Hospital, Kisumu County, Kenya.

Abstract

HIV/AIDS is considered a global burden and imposes significant strain and burden to the healthcare systems. Majority of new HIV infections annually occur in Sub-Saharan Africa. Kenya records significant mortalities and morbidities due to HIV/AIDS. Nonetheless, it has put in appreciable effort in implementing programs geared at reducing HIV prevalence. PrEP is one of the preventive measures approved by the Kenyan government. It was first launched in the year 2016 and rolled out nationally in 2017. However, there are still gaps in PrEP uptake to date and it’s utilization among the populations at risk of getting HIV infection are still suboptimal. This study sought to assess the determinants of PrEP uptake at Ahero County Hospital which is located in Nyanza region which is known to record high HIV infection prevalence rates. The study adopted a retrospective cross-sectional study design which involved abstraction of data from the PrEP registers, Client clinical encounter form (PrEP Cards), and RAST forms for all individuals eligible for PrEP as well as those initiated on PrEP in the year 2019. Probit model was applied in the empirical analysis of data obtained. Findings from this study indicate significant determinants that influence whether an eligible individual gets initiated of PrEP include age, gender, point of entry and the presence of risk factors such as HIV positive partner, sexual partner’s unknown HIV status, recent STI, and sex under the influence of alcohol. The age group found at high risk of HIV infection is 15-24years, however, PrEP uptake associated with this age group is also significantly low. PrEP uptake still remains at low levels than expected with less than 50% of those found at risk of contracting HIV not going ahead to use PrEP. The entry points play a crucial role and entry points that capture the generation at most risk i.e. PEER centers as well as VCT are highly recommended to be given more consideration being the point of entry most accessed by age set at most risk.