{
  "abstract": "Objectives To evaluate the associations between depressive symptoms, HIV vulnerability factors and oral pre-exposure prophylaxis (PrEP) use and adherence among adolescent girls and young women (AGYW) in Kenya.Design Cross-sectional observational study.Setting Research site in Kisumu, Kenya.Participants 300 AGYW aged 19–24 years (median age 21 years, IQR 20–22), attending follow-up visits in a randomised controlled trial of the efficacy of a single-dose HPV vaccine.Interventions Participants responded to questionnaires assessing their depressive symptoms (Patient Health Questionnaire-9), HIV vulnerability and PrEP use and adherence.Results Moderate to severe depressive symptoms were reported by 14.3% (95% CI 10.5% to 18.8%). Factors associated with increased prevalence of depressive symptoms included medium HIV risk perception (adjusted prevalence ratio (aPR) 2.25; 95% CI 1.20 to 4.26) and engaging in transactional sex (aPR 2.51; 95% CI 1.15 to 5.48). The rate of oral PrEP use was 19.3% (n=58, 95% CI 15.0% to 24.0%), with 43.0% reporting adherence (≥5 doses in the past week). Depressive symptoms were not significantly associated with PrEP use (aPR 0.94; 95% CI 0.52 to 1.70).Conclusions The high prevalence of depressive symptoms among AGYW highlights the importance of integrating mental health screening into HIV prevention services, particularly for individuals with higher HIV risk perception and those engaging in transactional sex.",
  "authors": [
    {
      "affiliations": [
        "Kenya Medical Research Institute, Centre for Microbiology Research, Nairobi, Kenya",
        "International Centre for Reproductive Health-Kenya, Mombasa, Kenya"
      ],
      "name": "Dismas Congo Ouma"
    },
    {
      "affiliations": [
        "Kenya Medical Research Institute, Centre for Microbiology Research, Nairobi, Kenya"
      ],
      "name": "George Otieno"
    },
    {
      "affiliations": [
        "University of Washington, Department of Biostatistics, Seattle, WA, USA"
      ],
      "name": "Anand Hemmady"
    },
    {
      "affiliations": [
        "Kenya Medical Research Institute, Centre for Microbiology Research, Nairobi, Kenya"
      ],
      "name": "Marion Wakhu"
    },
    {
      "affiliations": [
        "Kenya Medical Research Institute, Centre for Microbiology Research, Nairobi, Kenya"
      ],
      "name": "Linda Jepkemoi"
    },
    {
      "affiliations": [
        "University of Washington, School of Medicine, Seattle, WA, USA",
        "University of Washington, Department of Obstetrics & Gynecology, Seattle, WA, USA"
      ],
      "name": "Elizabeth K Harrington"
    },
    {
      "affiliations": [
        "Kenya Medical Research Institute, Centre for Microbiology Research, Nairobi, Kenya"
      ],
      "name": "Maricianah Onono"
    },
    {
      "affiliations": [
        "Kenya Medical Research Institute, Centre for Microbiology Research, Nairobi, Kenya",
        "International Centre for Reproductive Health-Kenya, Mombasa, Kenya",
        "University of Washington, School of Medicine, Seattle, WA, USA"
      ],
      "name": "Elizabeth A Bukusi"
    },
    {
      "affiliations": [
        "University of Washington, School of Medicine, Seattle, WA, USA",
        "University of Washington, Department of Global Health, Seattle, WA, USA"
      ],
      "name": "Susan Graham"
    }
  ],
  "title": "Evaluation of depressive symptoms, HIV vulnerability and oral PrEP use and adherence among adolescent girls and young women in Western Kenya: a cross-sectional study",
  "uid": "ca613cc1-9dda-5837-8074-f2cd3b2c834b"
}