DISCUSSION
prevention‐effectiveness, HIV serodifferent couples
In this evaluation of a large programmatic PrEP project in Kenyan public health HIV care clinics, we found moderate continuation on PrEP with a high drop‐off for most clients within 6 months post‐initiation that was characterized by four unique PrEP continuation patterns. More than a third of the individuals exhibited high continuation and coverage patterns on PrEP throughout the first year of use and about two fifth never returned for PrEP refill after initiation.For HIV prevention as opposed to treatment, effective PrEP use is not lifelong but means aligning PrEP use with periods of elevated HIV risk objectively or perceived (i.e. prevention‐effectiveness adherence) [We found that differentiation of coverage and continuation patterns between the four trajectories emerged within 1 month post‐PrEP initiation consistent with patterns of persistence observed for daily medication in other prevention fields [We previously demonstrated that for HIV serodifferent couples [This work has several limitations. First, latent class analysis is an exploratory data‐driven evaluation for which, the emergent number of classes depends on the sample size and study time. In this analysis, the large study population permitted more than sufficient power to identify clinically meaningful trajectories. Second, the final class selection and naming of trajectories is based on the researcher judgement which may not be replicable [