Mystery Shopper Assessment of PrEP Service Delivery Quality for Adolescent Girls and Young Women in Kenya: A Cross-sectional Study.

Providers were assessed by actors portraying patients, not by real adolescent girls and young women, so the findings describe simulated encounters rather than actual patient outcomes. Only 1% of cases were aborted because a provider detected the mystery shopper, but detection could still have biased some encounters toward better behavior. 232 providers consented, but not all necessarily had an encounter, and some providers may have had more than one visit, so the number of providers actually assessed is not clear. The study was a cross-sectional baseline assessment in one county in Kenya, so it does not show that training or other changes improved PrEP care. Recall of encounters may have been imperfect despite brief checklists, and different actors portraying the same case may have scored encounters differently. Facilities were purposively selected from sites that had participated in PrEP implementation and mentorship programs, so they may not represent all clinics.

The authors report no real or perceived vested interests related to this article that could be construed as a conflict of interest. The publication types list NIH and non-U.S. government research support.

Do not read the communication score of 72.8 as evidence that PrEP care was acceptable. Guideline adherence averaged 31.4, and in 36.5% of encounters shoppers said they would not seek care from that provider again.