Most Kenyan women who begin taking HIV prevention pills do not go past the first month, a study has found.
Forty-five days after starting pre-exposure prophylaxis (PrEP),59 per cent of women stop taking the pill, and the number of defaulters rises to 76 per cent after three months.
At six months, only 15 per cent of the women were still on the pill in a study conducted in Kisumu.
The findings were published on Tuesday in the open-access journal PLOS Medicine.
"Greater efforts to support PrEP normalisation and persistence for African women are needed," said Kenneth Mugwaya, a University of Washington researcher who led the study.
He said most women who continued to use the pill had HIV-positive male partners.
The results are not surprising, because studies in other parts of the world show retention rates for PrEP are deplorable.
Researchers are now scratching their heads on how to get more people to take the drugs and stay on them.
The Kisumu study was funded by the Dreams Innovation Challenge, a project of the US government, the Bill & Melinda Gates Foundation, Girl Effect NGO, and US drugs manufacturers Johnson & Johnson, Gilead Sciences, and ViiV Healthcare.
The study said the most frequently reported reason for discontinuing PrEP was low perceived risk of HIV (25 per cent).
The other reason was the knowledge that the partner was HIV negative (24 per cent), experiencing side effects (20 per cent), and pill burden (17 per cent).
However, the study proved that providing Prep at family planning clinics in Kenya was feasible.
Mugwaya said this was the main goal of the study, carried out between November 2017 and June 2018, among women aged 15 to 45 seeking family planning services at eight public health clinics.
"We found that FP clinics can be an effective platform to efficiently reach HIV at-risk women who may benefit from PrEP," he said.
Prep is a daily course of ARVs taken by HIV-negative people to protect themselves from infection.
Evidence shows that, when taken consistently and correctly, PrEP reduces the chances of HIV infection to near-zero.
Most of the women who took part in the study were married and reported recent condomless sex.
Gilead's Truvada drug was the first Prep approved in Kenya in April 2017.
Around 44,000 Kenyans are currently taking Prep, making it Africa’s largest such programme according to the Ministry of Health.
Dr Irene Mukui of the National Aids and STIs Control Programme said user discontinuation was one of the biggest challenges in the programme.
"Health officials need to better understand the perceptions, preferences and misconceptions of potential PrEP users and then develop strategies to address these," she said.
