Eligibility and Acceptability of Same-Day HIV Preexposure Prophylaxis Initiation During Emergency Care Encounters in Nairobi, Kenya: A Cross-Sectional Study.

Offorjebe OA, Ochola E, Ngila B, +16 more, Aluisio AR.

research-articleOpen access

AI summary — for doctors, generated from the abstract only

In a Nairobi emergency department, 16% of patients were PrEP-eligible and about three quarters said they would start PrEP the same day.

What was studied

A cross-sectional study at Kenyatta National Hospital emergency department (5 July to 18 August 2024) continuously screening nonpregnant, nonincarcerated adults, assessing PrEP eligibility by national guidelines and willingness to start same-day PrEP, with multivariable regression of acceptability correlates.

Key findings

Among 325 participants (median age 31, 56.3% male, 15.3% from key populations), PrEP eligibility was 16.0% and willingness 74.6%
Among key populations, eligibility was 28.6% and acceptability 73.5%
Correlates of acceptability were having a primary or regular sex partner (aOR 2.26, 95% CI 1.20-4.24) and multiple partners in the past 3 months (aOR 2.36, 95% CI 1.29-4.33)
Injectable PrEP was preferred by 62.5% and a six-month dispensing interval by 70.0%

Clinical relevance

Emergency departments may be viable sites for PrEP initiation in this setting, though the study measured stated willingness rather than actual uptake or continuation.

Who should care

Infectious Disease

Limitations

Single-centre cross-sectional study over six weeks measuring hypothetical willingness, without follow-up on initiation or persistence.

Emergency care visits could be an untapped opportunity to start PrEP in Nairobi.

This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.

Abstract

Background

Emergency departments (EDs) provide care to higher-risk and underserved populations for HIV services. This study evaluated eligibility and acceptability of same-day HIV preexposure prophylaxis (PrEP) initiation among persons seeking emergency care in Nairobi, Kenya.

Design

Cross-sectional study.

Methods

ED patients were continuously screened at Kenyatta National Hospital (5 July to 18 August 2024). Nonpregnant and nonincarcerated persons aged ≥18 years were enrolled. Data were collected on socio-demographics, health characteristics, and PrEP aspects. PrEP eligibility was based on national guidelines. Acceptability was defined as participants reporting willingness to initiate same-day PrEP, if indicated. Multivariable regression assessed factors associated with acceptability of ED-PrEP initiation, reported as adjusted odds ratios (aOR) with 95% confidence intervals (CI).

Results

Among the 325 enrolled participants (median age: 31 years), 56.3% were male and 15.3% were from key populations. PrEP-eligibility was 16.0%, and 74.6% of participants reported willingness to initiate same-day PrEP. For persons from key populations, PrEP eligibility was 28.6%, and acceptability was 73.5%. Correlates of same-day PrEP initiation included having a primary/regular sex partner (aOR = 2.26, 95% CI: 1.20 to 4.24, P = 0.01) and multiple sex partners in the past 3 months (aOR = 2.36, 95% CI: 1.29 to 4.33, P = 0.01). Injection was the preferred PrEP formulation (62.5%), with 70.0% preferring a six-month dispensing interval.

Conclusion

High PrEP eligibility and acceptability suggest that emergency care settings in Kenya are strategic PrEP programming venues, with potential to expand access to underserved populations. Further research is warranted to inform strategies to implement PrEP in ED settings in Kenya and other similar settings.

DOI

10.1097/qai.0000000000003911

PMID

42357991

PMCID

PMC13566360

Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.

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