| dc.description.abstract | HIV/AIDS remains a major global public health threat despite the emergence of
biomedical prevention strategies such as HIV Pre Exposure Prophylaxis and Post
Exposure Prophylaxis. Despite their efficacy, utilization rates are low among youths
aged 15-24, who account for approximately 27% of new infections globally and 33% in
Kenya. While the determinants of HIV Pre Exposure Prophylaxis and Post Exposure
Prophylaxis usage have been documented among men who have sex with men, female
sex workers, adolescent girls, and women, there are limited studies focusing on young
adults, a high-risk population for HIV infection. This study aimed to address this gap by
focusing specifically on young adults aged 18-24 in Khwisero sub-county, Kenya. The
study investigated the prevalence and determinants of HIV Pre Exposure Prophylaxis
and Post Exposure Prophylaxis use among young adults, with specific objectives
including the determination of uptake prevalence and the exploration of demographic,
health system, and socio-cultural determinants. Guided by the Health Belief Model, a
cross-sectional design was adopted. The target population comprised young adults aged
18-24, with a sample size of 426 respondents determined using the Yamane formula.
Two wards in Khwisero Sub-County were selected using simple random sampling, and
systematic sampling was employed to select young adults from community units within
these wards. Quantitative data were collected via a semi-structured questionnaire, while
qualitative data were obtained through Key Informant Interviews. The Statistical
Package for Social Sciences version 26 was used to analyze quantitative data through
descriptive and inferential statistics, including chi-square and logistic regression at a
significance level of 0.05. Thematic analysis was employed for qualitative data, and
findings were presented in tables, figures, narratives, and direct quotes. The study
revealed low prevalence of Pre Exposure Prophylaxis (23.4%) and Post Exposure
Prophylaxis (22.6%) utilization. Significant determinants of Pre Exposure Prophylaxis
use included education level (χ2=8.1, OR=0.21, P=0.04), religion (χ2=5.0, OR=0.40,
P=0.03), affordability (χ2=9.74, AOR=1.89, P=0.002), provider-initiated counseling
(χ2=17.09, AOR=2.69, P<0.001), and stigma (AOR=0.37, P=0.002). Factors affecting
Post Exposure Prophylaxis utilization encompassed education level (χ2=17.76,
OR=0.43, P<0.001), marital status (χ2=6.47, OR=0.33, P=0.04), living arrangement
(χ2=9.91, OR=1.95, P<0.001), and provider-initiated counseling (χ2=5.71, AOR=1.49,
P=0.02). Qualitative data highlighted additional factors such as adherence support and
cultural beliefs. These results highlight the urgent need for targeted interventions to
enhance Pre Exposure Prophylaxis and Post Exposure Prophylaxis utilization among
young adults. By addressing the identified barriers and leveraging facilitators,
policymakers can formulate strategies and interventions to strengthen uptake,
ultimately reducing new HIV infections among young adults. | en_US |
