{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T08:48:51Z","timestamp":1768034931122,"version":"3.49.0"},"reference-count":40,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,2,20]],"date-time":"2024-02-20T00:00:00Z","timestamp":1708387200000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["R34MH122362"],"award-info":[{"award-number":["R34MH122362"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Young women in sub\u2010Saharan Africa are a priority population for HIV prevention, yet challenges with adherence and persistence to HIV pre\u2010exposure prophylaxis (PrEP) are common. This study involved the development and pilot testing of My Way\u2014a novel delivery system for PrEP and co\u2010packaged sexual health services.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>My Way was developed in Kisumu, Kenya through a user\u2010centred design process (2020). The intervention involves peer\u2010delivery and support for HIV testing and PrEP use, self\u2010collected vaginal swabs for sexually transmitted infection (STI) testing, pregnancy testing, oral contraceptive pills, self\u2010injectable medroxyprogesterone and\/or condoms. My Way was assessed among 16\u2010 to 24\u2010year\u2010old sexually active women in a randomized controlled trial versus standard of care (SoC; 2021\u20132022). Use of PrEP and other sexual health services were tracked at 1, 3 and 6 months for feasibility. Acceptability was determined by questionnaire. The effect of the intervention on tenofovir diphosphate (TFV\u2010DP) levels was assessed by chi\u2010square test (primary outcome); other predictors were explored with regression analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 150 women, the median age was 22 years and the median number of sexual partners was 2. Moderate\/severe depression was common (60%). In the intervention arm, peers made 88% (198\/225) of possible kit deliveries (177 with PrEP) and 49 STIs were diagnosed. In the SoC arm, 24% (55\/225) of expected clinic visits occurred (53 with PrEP); no STI testing was performed. TVF\u2010DP was detected in 16 participants at 6 months: 16% (12\/75) in the intervention arm versus 5% (4\/75) in the SoC arm (<jats:italic>p<\/jats:italic> = 0.03). Persistence among those with ongoing HIV prevention needs (i.e. prevention\u2010effective persistence)\u00a0was 18% (12\/67) versus 7% (4\/56; <jats:italic>p<\/jats:italic> = 0.08). No women acquired HIV. The intervention was significantly associated with detectable TFV\u2010DP (OR 3.5, 1.1\u201011.4; <jats:italic>p<\/jats:italic> = 0.04); moderate\/severe depression trended towards an association with TFV\u2010DP (OR 0.2, 0.03\u20131.6; <jats:italic>p<\/jats:italic> = 0.13).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>My Way is a promising delivery system for PrEP and other sexual health services among young women in Western Kenya. We found high feasibility and acceptability. PrEP use was modest, but higher with My Way compared to SoC. Long\u2010acting PrEP formulations may overcome important barriers to PrEP use and should be explored in combination with the My Way delivery model.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.26217","type":"journal-article","created":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T04:37:04Z","timestamp":1708490224000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["My Way: development and preliminary evaluation of a novel delivery system for PrEP and other sexual health needs of young women in Western Kenya"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5845-3190","authenticated-orcid":false,"given":"Jessica E.","family":"Haberer","sequence":"first","affiliation":[{"name":"Massachusetts General Hospital  Boston Massachusetts USA"},{"name":"Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Oware","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute  Kisumu Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lawrence","family":"Juma","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute  Kisumu Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernard","family":"Nyerere","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute  Kisumu Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincent","family":"Momanyi","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute  Kisumu Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josephine","family":"Odoyo","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute  Kisumu Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lindsey","family":"Garrison","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julita","family":"Bhagat","sequence":"additional","affiliation":[{"name":"Ark Africa  Nairobi Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Musinguzi","sequence":"additional","affiliation":[{"name":"Global Health Collaborative  Mbarara Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8242-8438","authenticated-orcid":false,"given":"Jared M.","family":"Baeten","sequence":"additional","affiliation":[{"name":"University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5553-7540","authenticated-orcid":false,"given":"Aaron","family":"Siegler","sequence":"additional","affiliation":[{"name":"Emory University  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth A.","family":"Bukusi","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute  Kisumu Kenya"},{"name":"University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,2,20]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"UNAIDS. 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