Risk Perception Among HIV Serodiscordant Couples in East Africa Taking Oral PrEP for HIV Prevention

Thesis (Master's)--University of Washington, 2015Levels of adherence varied across trials for pre-exposure prophylaxis (PrEP) for HIV prevention. One hypothesis for this inconsistency is that low perceived risk of HIV infection drove low adherence in trials where PrEP produced no reduction in risk. Using a mixed methods approach, we explored the level of perceived risk of incident HIV infection in the Partners PrEP Study, in which adherence was generally high. The Partners PrEP Study followed 4747 serodiscordant couples in Kenya and Uganda. A brief cross-sectional survey assessed perceived risk of HIV via questionnaire at 12 months after enrollment. Logistic regression was used to analyze the relationship between perceived risk and demographic variables, sexual behavior, and other objective measures of risk. 3226 couples from the Partners PrEP Study were included in this analysis. Perceived risk was low across the entire study cohort, with only 15.4% of participants reporting high or moderate perceived risk. Participants objectively assessed to be at higher risk for HIV were more likely to report high perceived risk (OR=1.60, 95%CI: 1.30-1.95, p