Factors Affecting Adherence to Prep Services Among Men Who Have Sex with Men in Nairobi Kenya

Abstract

Kenya has rolled out PrEP among MSM but retention rate was reported below 40% at month three of PrEP initiation. This study sort to offer an intervention on targeted counseling to one group of MSM and had a control group who did not access the intervention. Experimental design was used whereby two MSM facilities were selected. Eligible MSM on PrEP for at most a week were selected through simple random sampling and randomized to either arm. Intervention arm received government PrEP services with personalized counseling sessions, control arm received PrEP government services only. 84 study participants enrolled on each arm. Factor affecting MSM retention on PrEP were assessed at month 1 and 6. Factors assessed were internal and external stigma, affordability, accessibility and criminalization of gay behavior. The intervention group was also evaluated on depression, alcohol abuse, drug substance abuse and adherence to PrEP appointments, whereby all were found to have a significant association to PrEP retention. Retention at month 1 and 6 in the intervention arm was 97.6%, and 69% respectively while control arm was 81%, and 19% respectively