Engagement in HIV prevention and preferences for long-acting injectable cabotegravir delivery in fishing communities along Lake Victoria, Kenya
Men in occupations that require high mobility, such as fishing, are particularly vulnerable to lapses in HIV prevention engagement. Kenya has been a leader in scaling up biomedical HIV prevention, including oral PrEP. However, in preliminary data from the Owete study, we found that uptake of HIV prevention, including daily oral PrEP, is low (3.8%) despite availability in government health facilities at no cost. Though biomedical tools exist to reduce HIV incidence, efforts to improve oral PrEP use have not been effectively deployed to address unique barriers experienced by this important population or considered how new HIV prevention technologies such as long-acting injectable cabotegravir (CAB-LA) can be delivered effectively to fisherfolk to optimize engagement in HIV prevention. The proposed mentored RAP research fills these gaps in knowledge by exploring engagement in oral PrEP among men working in the fishing industry in Kenya and contextual factors and preferences that could influence CAB-LA uptake and persistence in fishing communities through two specific aims. Aim 1 will explore oral PrEP motivations, access, and usage patterns among men residing in fishing villages leveraging pre-coded data from recently conducted qualitative in-depth interviews (IDIs) with 65 men at baseline of the Owete trial. Aim 2 will evaluate context and preferences for CAB-LA delivery through IDIs with Owete study participants (N=30) and focus groups discussions with key informant healthcare providers from Owete clinics (N=2). Data will be analyzed thematically. Findings from Aims 1 and 2 will be integrated and used to develop recommendations for differentiated service delivery options to optimize fisherfolk’s engagement in HIV prevention. This research will be mentored by experienced UCSF and Kenyan mentors and will form the basis through important preliminary data for a future K01 proposal which will support Dr. Nishimura in becoming an independent HIV investigator.