Felix Mogaka, MBChB, MPH
Nominated From: University of Minnesota
Research Site: Kenya Medical Research Institute
Research Area: STI, STI prevalence, Men, HIV PrEP, STI prevention, Doxycycline PEP
Primary Mentor: Jenell Stewart
Research Project
Prevalence of Bacterial STIs, Sexual Behavior, and Acceptability of Doxycycline Post-Exposure Prophylaxis for STI Prevention among Men using HIV Prep in Kisumu County.
The incidence and prevalence of curable bacterial sexually transmitted infections (STIs) are high and rising globally, especially among populations using HIV pre-exposure prophylaxis (PrEP). Untreated, STIs have severe consequences and contribute to significant disability adjusted years (DALY’s). In Eastern and Southern Africa, STI rates are high among sexually active adolescent girls and young women (AGYW) as well as among men who have sex with men (MSM). Among MSM in Kenya, the few studies reporting STI prevalence have reported prevalence of curable bacterial STIs of up-to 58%, with limited data on the prevalence of STIs among male PrEP users regardless of sexual behavior (i.e, MSM, heterosexual, etc.) Men could be an important bridge in STI transmission and persistence among both homosexual and heterosexual networks, particularly men who engage in bisexual contact, with studies among MSM in Kenya that up-to two thirds of MSM engage in sex with women. There is limited data on the burden of STIs among men using HIV PrEP regardless of classification by sexual behavior or location of PrEP delivery; the proportion of men on PrEP who exclusively have sex with women, proportion that exclusively have sex with men, and proportion that have sex with both men and women. Filling this evidence gap could inform understanding of STI transmission dynamics among men and women at high risk of STIs and inform high-yield strategies to reverse the persistence of STIs and prevent STIs in both men and women. Lastly, among people assigned male at birth, doxycycline PEP has shown efficacy in preventing chlamydia and syphilis, but there are no published studies in Kenya on the acceptability of this strategy among men using PrEP in Kenya. We will evaluate the acceptability of doxycycline PEP in this population that stands to benefit from it.
Research Significance
Findings from this study will provide estimates of STI prevalence among men using PrEP, describe the extent of bisexual contact with women and provide early findings on acceptability of doxycycline PEP among men in Western Kenya. These findings will inform subsequent strategies to control STIs among men and women at high risk of STIs in Kenya.
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