In this prospective cohort nested within a Kenyan pragmatic PrEP delivery trial, researchers followed sexually active HIV–negative women aged ≥15 at elevated HIV risk from June 2021 to February 2024, assessing PrEP initiation/use and bacterial STI incidence. Urine NAATs (Gonorrhoeae and Chlamydia) tested at quarterly visits provided incident STI data.
The primary exposure was self-reported PrEP initiation and consistency through 6 months, categorized as never, inconsistently, or consistently on PrEP. Multivariable modified Poisson GEE models adjusted for prespecified baseline covariates (age, baseline STI, contraceptive use, number of partners, education, marital status, partner’s HIV status, transactional sex, clinic site) were used to estimate associations with incident STI; intracluster correlation across clinics was negligible.
Among 650 enrolled women, 60% initiated PrEP at baseline; median age was 26 years. At enrollment, 11% had an STI.
Over follow-up, 19.1% developed at least one STI, with no significant difference between baseline PrEP initiators and decliners (aRR ~1.11; 95% CI wide, p=0.58). Consistent PrEP users had lower STI incidence than non-users, though not statistically significant (aRR 0.56; 95% CI 0.27–1.19).
PLOS Medicine published a clinical update in Research Highlights on 09 Mar 2026.
The item focuses on Oral preexposure prophylaxis use and the risk of bacterial sexually transmitted infections and HIV among African women: A prospective observational cohort study.
Review the original article for the full source wording and details.