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Pamela Kohler, PhD, MPH, RN, is an Associate Professor of Global Health and Child, Family, and Population Health Nursing at the University of Washington, Seattle, Washington, USA. Anna Larsen, MPH, is a PhD Candidate in the Department of Epidemiology at the University of Washington, Seattle, Washington, USA. Joseph Sila, BSc, is a Data Analyst with Kenyatta National Hospital, Kisumu, Kenya. Kate Wilson, PhD, was a Research Scientist with the Department of Global Health, University of Washington, Seattle, Washington, USA. Felix Abuna, BA, is a Project Director with Kenyatta National Hospital, Kisumu, Kenya. Harison Lagat, BSN, MPH, RN, is a Research Coordinator with Kenyatta National Hospital, Kisumu, Kenya, and PhD Student at the University of Washington School of Nursing, Seattle, Washington, USA. George Owiti, RN, is a Research Coordinator with Kenyatta National Hospital, Kisumu, Kenya. Tamara Owens, PhD, is the Director of the Clinical Skills and Simulation Center at Howard University, Washington, DC, USA. Jillian Pintye, PhD, MPH, RN, is Assistant Professor of Biobehavioral Nursing and Health Informatics at the University of Washington, Seattle, Washington, USA. Barbra Richardson, PhD, is a Statistician with the Department of Biostatistics at the University of Washington, Seattle, Washington, USA. Grace John-Stewart, MD, PhD, is a Professor of Global Health, Epidemiology, Pediatrics, and Allergy and Infectious Diseases at the University of Washington, Seattle, Washington, USA. John Kinuthia, MBChB, MPH, is Head of the Department of Research and Programs at Kenyatta National Hospital, Nairobi, Kenya.
Published: August 2022
AI Article Synopsis
Article Abstract
Pre-exposure prophylaxis (PrEP) uptake and adherence among adolescent girls and young women (AGYW) may be negatively influenced by poor interactions with health care providers. We assessed PrEP counseling using unannounced standardized patient actors (USPs) at routine care clinics in Kenya. Trained actors posed as AGYW seeking PrEP services following case scripts and completed a checklist of provider adherence to national guidelines and communication skills. Scores were converted into a percentage and compared using linear regression. The overall mean quality score was 52.1 and varied across case scripts: a married new initiator yielded higher scores than portrayals of adherence/stigma challenges, transactional sex, and a minor adolescent. Mean guideline scores (31.4) were lower than communication scores (72.8), although in 36.5% of encounters, USPs stated they would not seek help from that provider again. Unannounced standardized patients reported provider reluctance to offer PrEP to AGYW. Interventions to strengthen provider counseling skills are needed.
