Background People who inject drugs (PWIDs) are disproportionately affected by HIV despite the availability of multiple efficacious biomedical prevention interventions including oral pre‐exposure prophylaxis (PrEP). Little is known about the knowledge, acceptability, and uptake of oral PrEP among this population in Kenya. To inform the development of oral PrEP uptake optimization interventions for PWID in Kenya, we conducted a qualitative assessment to establish oral PrEP awareness and willingness to take PrEP by this group in Nairobi City. Methodology Guided by the capability, opportunity, motivation, and behavior (COM‐B) model of health behavior change, we conducted eight focus group discussions (FGDs) among randomly constituted samples of PWID in four harm reduction drop‐in centers (DICs) in Nairobi in January 2022. Although the FGDs were conducted in the harm reduction DICs, only few of the participants were utilizing DICs services. The domains explored were perceived risks (behavior), oral PrEP awareness and knowledge (capability), motivation to use oral PrEP (behavior), and perceptions on community uptake (motivation and opportunity). Completed FGD transcripts were uploaded to Atlas.ti version 9 and thematic analysis was conducted through an iterative process of review and discussion by two coders. Findings There was a low level of oral PrEP awareness with only four of the 46 PWID having heard of PrEP; only few participants had ever used oral PrEP, and they were no longer using it, indicating a low capacity to make decisions on oral PrEP. Study participants were aware of the risk posed by unsafe drug injection and expressed willingness to take oral PrEP. Participants demonstrated low understanding of the role oral PrEP plays in complementing condoms in HIV prevention, presenting an opportunity for awareness creation. While the PWID were eager to learn more about oral PrEP, they favored DICs as places where they would like to obtain information and oral PrEP if they chose to use it, identifying an opportunity for oral PrEP programming interventions. Conclusion Creation of oral PrEP awareness among PWID in Kenya is likely to improve uptake since the PWID are receptive. Oral PrEP should be offered as part of combination prevention approaches, and effective messaging through DICs, integrated outreaches, and social networks are recommended to mitigate displacement of other prevention and harm reduction practices by this population. Trial Registration ClinicalTrials.gov identifier: STUDY0001370
Cosmas et al. (Thu,) studied this question.