Shauriana Randomised Controlled Trial

Study Long Title: Acceptability, Feasibility, and Safety of the Shauriana Intervention for Young Kenyan Gay, Bisexual, and Other Men Who Have Sex with Men, and Exploration of Potential Impact on Sexual Health Outcomes
Background: Gay, bisexual, and other men who have sex with men (GBMSM) in Kenya are at a higher risk of HIV acquisition. However, uptake and adherence to pre-exposure prophylaxis (PrEP) have been suboptimal within this group. To address this issue, we collaborated with GBMSM community leaders in Kisumu to develop the Shauriana intervention, a culturally tailored HIV prevention program designed to enhance sexual health and well-being for young Kenyan GBMSM.
Intervention Design: The Shauriana intervention consisted of five peer-led sessions, which included topics like rapport building, sexual health basics, relationships, stress and coping, and healthy sexuality and empowerment. Additionally, Next Step Counseling was integrated into the program to help participants explore their goals for PrEP use, other HIV prevention strategies, and overall well-being.

Study Methodology: Conducted between 2019 and 2021, this randomized controlled trial (RCT) included 60 participants. The study aimed to assess the acceptability, feasibility, and safety of the intervention and its potential impact on sexual health outcomes, particularly PrEP use. Participants were followed for 6 months, and results were compared to those receiving standard care.
Key Findings: The study exhibited a high retention rate, with 93.1% of participants in the intervention group retained at 6 months, compared to 87.1% in the standard care group. All participants in the intervention group completed all five sessions, and 62.1% attended an additional optional session.
Concerning sexual health outcomes, participants in the intervention group were more likely to report condom use at last sex (adjusted incidence rate ratio of 1.45). Higher PrEP knowledge and borderline higher prevention self-efficacy scores were observed in the intervention group. Despite these positive outcomes, PrEP use remained low, with fewer than 10% of participants having protective levels of PrEP at each time point.
Conclusion: The Shauriana intervention demonstrated high acceptability and feasibility and showed positive trends in improving sexual health outcomes. However, low PrEP use among participants highlights the need for continued research to refine interventions that address the comprehensive needs of young GBMSM, including both sexual health and well-being.
Funding: This study was supported by NIMH grant R34MH118950. SMG was additionally supported by the University of Washington Behavioral Research Center for HIV (BIRCH), funded by NIMH (P30 MH123248).