Effect of enhanced peer PrEP referral with HIV self-testing delivery among young Kenyan women: A randomized controlled trial of peer networks

by Katrina F. Ortblad, Njeri Wairimu, Carlos Culquichicon, Irene Njeru, Rachel C.

Malen, Adriana M. Reedy, Obinna Ekwunife, Maureen McGowan, Margaret Mwangi, Agata Muthoni, Dorcas Kiboi, Sarah Njoroge, Fei Gao, Jared M.

Baeten, Kenneth Ngure Background Adolescent girls and young women (AGYW) in Africa experience high HIV acquisition risk and low engagement in prevention services. Knowledge of HIV–negative status paired with peer support might motivate AGYW—who are highly socially connected—to initiate HIV prevention services, including pre-exposure prophylaxis (PrEP).

Methods and findings We conducted a randomized controlled trial (ClinicalTrials.gov: NCT04982250) of AGYW peer networks in Central Kenya. Index peers aged 16–24 years who had used oral PrEP in the past 12 months were randomized 1:1 to: (1) enhanced peer referral: group training on PrEP referral strategies and delivery of HIV self-testing (HIVST) kits ( n = 8 kits, 2 kits/peer); or (2) standard peer referral: informal PrEP referral strategies.

Index peers were encouraged to refer four peers who could benefit from PrEP.