AUTHOR=Nyaboe Edward , Larsen Anna , Sila Joseph , Kinuthia John , Owiti George , Abuna Felix , Kohler Pamela , John-Stewart Grace , Pintye Jillian 

TITLE=Contraceptive Method Mix and HIV Risk Behaviors Among Kenyan Adolescent Girls and Young Women Seeking Family Planning Services: Implications for Integrating HIV Prevention

JOURNAL=Frontiers in Reproductive Health

VOLUME=Volume 3 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/reproductive-health/articles/10.3389/frph.2021.667413

DOI=10.3389/frph.2021.667413

ISSN=2673-3153

ABSTRACT=Understanding HIV risk behaviors among adolescent girls and young women (AGYW) seeking contraception could help inform integrating HIV prevention services within family planning (FP) clinics. From 10/2018 to 04/2019, we conducted a survey at 4 FP clinics in Kisumu, Kenya to evaluate risk behaviors among AGYW without HIV infection seeking contraception. All AGYW aged 15-24 were invited to participate following receipt of FP services. AGYW initiating or refilling contraception were included in this analysis. Long-acting reversible contraceptives (LARC) included intrauterine devices, implants, or injectables. Non-LARC methods included oral contraceptive pills or condoms. We used an empiric risk score to assess HIV risk behaviors; HIV risk scores of ≥5 (corresponding to 5-15% HIV incidence) defined “high” HIV risk. Overall, 555 AGYW seeking FP were included. Median age was 22 years (interquartile range [IQR] 20-23), median completed education was 12 years (IQR 10-12); 23% of AGYW had HIV risk scores of ≥5. The most frequent form of contraception was injectables (43%), followed by implants (39%). After adjustment for education, prior pregnancy, and marital status, LARC users more frequently engaged in transactional sex than non-LARC users (6% vs. 0%, adjusted prevalence ratio[PR]=1.17, 95% CI 1.09-1.29, p<0.001). Among LARC users, AGYW using injectables more frequently had condomless sex compared to AGYW using other LARC methods (85% vs. 75%, adjusted PR=1.52, 95% CI 1.09-2.10, p=0.012). AGYW seeking contraception frequently had high HIV risk, emphasizing the importance of integrating HIV prevention within FP. Multipurpose technologies for contraception and HIV prevention could particularly benefit AGYW.