Willingness to Test for HIV and Initiate Post-exposure Prophylaxis Among Adolescent Girls and Young Women Seeking Emergency Contraceptive Pills in Pharmacies in Nairobi and Kisumu, Kenya: A Longitudinal Study.
Nicholas Kipkurui, Gerald Owuor, Dorothy Oketch and 4 others
PMID 41668246WHAT IT FOUND
79% of young women seeking emergency contraception in Kenyan pharmacies wanted HIV testing, and 73% wanted PEP, but only 10.5% of followed-up participants tested and started PEP.
Interest did not equal uptake.
Key findings
01Among 200 enrolled young women aged 15 to 24 at five pharmacies, 79% were interested in pharmacy-based HIV testing and 62.6% preferred self-testing, while 86.5% knew PEP and 73% were interested in pharmacy-initiated PEP, but only 11.8% had ever used PEP; 41.5% and 28.5% reported high or moderate HIV risk, yet 52.3% had not tested within 6 months.
02At 10-day follow-up, 50.7% of 150 participants linked to HIV prevention services; among those linked, 68.4% sought services at a pharmacy, 25% at a public facility, and 6.6% at a private facility, but only 10.5% tested and initiated PEP.
03Interest in pharmacy-based HIV testing was higher when the last HIV test was more than 3 months ago or perceived risk was medium/high, and lower among those with postsecondary education, those married or in a union, and those already aware of PEP.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The pharmacies were in informal settlements, so results may not apply to larger pharmacies in more formal or higher-income areas. Most participants had postsecondary education, so views may not represent young women with less formal education. Follow-up was available for 150 participants, while 200 were enrolled; the paper does not report how many were lost. Outcomes were self-reported after a phone survey, so recall and social desirability bias could affect testing and PEP uptake. The study had no comparison group and was exploratory, so it cannot show that pharmacy counselling or informational sheets caused HIV testing or PEP initiation.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read the 10.5% PEP initiation as proof that pharmacy counselling or informational sheets cause uptake. There was no comparison group, outcomes were self-reported, and the authors state the findings are associative, not causative.