Acceptability of pre-exposure prophylaxis and associated factors among Adolescent Girls and Young Women in Kenya: Analysis of the 2022 Kenya demographic and health survey.
Based on the 2022 Kenya Demographic and Health Survey, this study reveals that while 73.7% of HIV-negative adolescent girls and young women in Kenya find pre-exposure prophylaxis (PrEP) acceptable, this willingness is significantly influenced by regional, ethnic, educational, religious, and sociocultural factors, highlighting the need for targeted, culturally responsive interventions to address the remaining 26.3% who do not accept PrEP.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
In the landscape of public health, few challenges are as persistent or as personal as the spread of HIV, particularly among young women in sub-Saharan Africa. While medical science has developed powerful tools to stop the virus before it takes hold, the success of these tools depends entirely on whether the people who need them are willing to use them. One such tool is pre-exposure prophylaxis, often called PrEP. Think of it as a daily shield: a person takes a pill every day to prevent infection if they are exposed to the virus. This approach is highly effective, but its power is only realized when people know it exists, trust it, and feel safe enough to take it. In Kenya, where young women face a significantly higher risk of infection than their male counterparts, health officials have worked for years to make this protection available. Yet, a gap remains between the medicine being offered and the medicine being accepted. Understanding why some young women embrace this protection while others hesitate is not just a matter of statistics; it is about uncovering the complex mix of culture, geography, and personal belief that shapes a woman's decision about her own health.
Researchers recently turned to a massive, nationwide snapshot of Kenyan life to answer this question. They analyzed data from the 2022 Kenya Demographic and Health Survey, a comprehensive census that interviewed thousands of households across the country. From this vast pool, they focused specifically on 1,668 adolescent girls and young women between the ages of 16 and 24. These were women who did not have HIV but were aware that PrEP existed. The team asked a simple, direct question: do you approve of people who take a pill every day to prevent getting HIV? By looking at the answers alongside details about where these women lived, their ethnic backgrounds, their education, and their family lives, the researchers could map out exactly what influences a young woman's willingness to protect herself.
The results revealed a landscape of hope mixed with specific, identifiable barriers. Overall, the willingness to accept this daily protection was high. Nearly three out of every four young women in the study said they would approve of taking the pill. This suggests that the basic idea of using medication to prevent HIV has taken root in the minds of many young Kenyan women. However, the study also showed that this acceptance was not uniform. It varied significantly depending on where a woman lived, who she was, and what she believed.
Geography played a major role. A young woman living in the Eastern, Nyanza, or Nairobi regions was significantly more likely to say yes to PrEP compared to a woman living in the Central region. This difference likely reflects the reality that HIV is not spread evenly across the country; some areas have historically faced higher rates of infection and have had more intensive health campaigns. When the risk feels more immediate and the services are more visible, the willingness to use protection grows. Similarly, a woman's ethnic background mattered. Those identifying as Luhya or Mijikenda/Swahili were more likely to accept the pill than those identifying as Luo. This points to the deep influence of cultural norms and community trust in healthcare decisions.
Education and religion also shaped these choices in surprising ways. The study found that women with tertiary education, such as university degrees, were actually less likely to accept PrEP than those with a secondary school education. This suggests that higher education does not automatically translate into a higher perceived risk of infection; some highly educated women may feel less vulnerable to the virus. Religion, too, was a factor. Women who belonged to religious groups other than Christianity, Islam, or the major established faiths were more likely to accept PrEP. In contrast, those who justified the idea of a husband beating his wife were less likely to accept the pill. This finding highlights a critical link between gender equality and health: when a woman feels she has the right to make her own decisions and is not bound by harmful norms of control, she is more likely to take charge of her own safety.
The desire for children also influenced the decision. Women who did not want more children were more open to taking PrEP than those who did. This is likely because of concerns about how the medication might affect pregnancy or breastfeeding, even though the medicine is generally considered safe. The study also noted that women who had never used alcohol or tobacco, and those who had good knowledge about how HIV spreads, were generally more accepting of the prevention tool.
These findings paint a clear picture for health officials. The high overall acceptance rate is a strong foundation, but the variations show that a single, blanket message will not work for everyone. To reach the remaining women who are hesitant, interventions must be tailored. In regions with lower acceptance, health workers may need to bring the message closer to home, using local languages and trusted community leaders. For highly educated women, the conversation might need to shift from general awareness to specific risk assessment, helping them see their own vulnerability. For those in communities where gender norms are restrictive, programs must address the fear of partner violence and empower women to make independent health choices. The study concludes that while the door to prevention is open for most young women in Kenya, keeping it open for all requires understanding the unique keys that unlock trust in different parts of society.
Drowning in papers in your field?
Get daily digests of the most novel papers matching your research keywords — with technical summaries, in your language.