Limitations
HIV serodifferent couples
This study had limitations. First, our HIV testing outcomes relied on self-reported data subject to social desirability bias. Second, we assumed that if participants did not return for follow-up, they did not achieve the outcomes of interest. It is possible, however, that clients might have continued HIV testing and not returned for follow-up or transferred to a different clinic. Third, our retention windows for the 6- and 12-month visits were wide and thus may not have captured more nuanced ways the intervention affected clients’ PrEP use (eg, late refill visits potentially indicative of gaps in PrEP coverage or stopping and restarting PrEP use). Fourth, our study population was limited to individuals in HIV serodifferent couples and women not in known HIV serodifferent couples, so the effects of this intervention within other priority populations remains unknown. Notably, we enrolled individuals refilling PrEP 1 month following initiation; thus, our findings may not have been the same had we enrolled individuals initiating PrEP. Additionally, this trial took place at 1 research clinic, resulting in PrEP care that might not be emblematic of what participants would have otherwise received at public clinics with more limited resources in Kenya or other similar settings, potentially limiting the generalizability of our findings.