Characteristics of Kenyan Women Enrolled in a Randomized Trial on Doxycycline Postexposure Prophylaxis for Sexually Transmitted Infection Prevention-Reference-Cited by-同舟云学术

Characteristics of Kenyan Women Enrolled in a Randomized Trial on Doxycycline Postexposure Prophylaxis for Sexually Transmitted Infection Prevention

Published:2022-11-02 Issue: Volume: Page:
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Author:

Oware Kevin¹,Adiema Lydia¹,Rono Bernard¹,Violette Lauren R.²,McClelland R. Scott³,Donnell Deborah⁴,Scoville Caitlin W.³,Odoyo Josephine¹,Baeten Jared M.⁵,Bukusi Elizabeth¹,Stewart Jenell⁶

Affiliation:

1. Kenya Medical Research Institute

2. University of Washington, Department of Medicine (Infectious Diseases)

3. University of Washington, Department of Global Health

4. Fred Hutchinson Cancer Research Center

5. Gilead Sciences

6. Hennepin Healthcare

Abstract

Abstract Introduction The global incidence of sexually transmitted infections (STIs) has been rapidly increasing over the past decade, with more than one million curable STIs being acquired daily. Young women in sub-Saharan Africa have a high prevalence and incidence of both curable STIs and HIV. The use of doxycycline as a prophylaxis to prevent STI infections is promising; however, clinical trials, to date, have only been conducted among men who have sex with men (MSM) in high-income settings. We describe the characteristics of participants enrolled in the first trial to determine the efficacy of doxycycline post-exposure prophylaxis (PEP) to reduce STI incidence among women. Methods This is an open-label 1:1 randomized clinical trial of doxycycline PEP efficacy to reduce incident bacterial STIs – Neisseria gonorrhoeae, Chlamydia trachomatis, and Treponema pallidum – among Kenyan women aged ≥18 and ≤30 years. All were also taking HIV pre-exposure prophylaxis (PrEP). We describe the baseline characteristics of participants. Results Between February 2020 and November 2021, 449 women were enrolled. The median age was 24 years (IQR 21–27), the majority were never married (66.1%), 370 women (82.4%) reported having a primary sex partner, and 33% had sex with new partners in the 3 months prior to enrolment. Two-thirds (67.5%, 268 women) did not use condoms, 36.7% reported transactional sex, and 43.2% suspected their male partners of having sex with other women. Slightly less than half (45.9%, 206 women) were recently concerned about being exposed to an STI. The prevalence of STIs was 17.9%, with C. trachomatis accounting for the majority of infections. Conclusion Young cisgender women using HIV PrEP in Kenya and enrolled in a trial of doxycycline postexposure prophylaxis had a high prevalence of curable STIs and represent a target population for an STI prevention intervention.

Publisher

Research Square Platform LLC

Reference22 articles.

1. Organization WH. World Health Organization. Global health sector strategy on sexually transmitted infections, 2016–2021: Towards ending STIs. WHO/RHR/1609 Geneva WHO; [Internet]. 2016 [cited 2022 Feb 22];20(1):58–63. Available from: https://www.who.int/reproductivehealth/publications/rtis/ghss-stis/en/.

2. Korenromp EL, Rowley J, Alonso M, Mello MB, Saman Wijesooriya N, Guy Mahiané S, et al. Global burden of maternal and congenital syphilis and associated adverse birth outcomes—Estimates for 2016 and progress since 2012. PLoS One. 2019 Feb 1;14(2).

3. Unemo M, Lahra MM, Escher M, Eremin S, Cole MJ, Galarza P, et al. WHO global antimicrobial resistance surveillance for Neisseria gonorrhoeae 2017–18: a retrospective observational study. The Lancet Microbe. 2021 Nov 1;2(11):e627–36.

4. HIV prevalence and associated risk factors among individuals aged 13–34 years in rural Western Kenya;Amornkul PN;PLoS One,2009

5. Stewart J, Bukusi E, Celum C, Delany-Moretlwe S, Baeten JM. Sexually transmitted infections among African women: an opportunity for combination sexually transmitted infection/HIV prevention. AIDS [Internet]. 2020 Apr 1 [cited 2022 Feb 9];34(5):651–8. Available from: https://pubmed.ncbi.nlm.nih.gov/32167988/.