Acceptability and feasibility of leveraging community‐based HIV counselling and testing platforms for same‐day oral PrEP initiation among adolescent girls and young women in Eastern Cape, South Africa

Medina‐Marino, Andrew; Bezuidenhout, Dana; Ngwepe, Phuti; Bezuidenhout, Charl; Facente, Shelley N.; Mabandla, Selly; Hosek, Sybil; Little, Francesca; Celum, Connie; Bekker, Linda‐Gail

doi:10.1002/jia2.25968

Cited by 20 publications

(20 citation statements)

References 61 publications

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“…This study was nested within the Community PrEP Study (CPS) [ 41 , 42 ]. CPS aimed to leverage community-based platforms to increase access and adherence to PrEP among young women in two high HIV burden communities in the Eastern Cape Province, South Africa (Fig.…”

Section: Methodsmentioning

confidence: 99%

What motivated men to start PrEP? A cross-section of men starting PrEP in Buffalo city municipality, South Africa

et al. 2023

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Background Compared to women, South African men are less likely to know their HIV status (78% vs. 89%), have suppressed viral loads (82% vs. 90%), or access HIV prevention services. To achieve epidemic control where heterosexual sexual behavior drives transmission, interventions to improve the uptake of HIV testing services (HTS) and prevention services must also target cis-gendered, heterosexual men. There is limited understanding of these men’s needs and wants with regards to accessing pre-exposure prophylaxis (PrEP). Methods Adult men (≥ 18 years) from a peri-urban community in Buffalo City Municipality were offered community-based HTS. Those who received a negative HIV test result were offered community-based, same-day oral PrEP initiation. Men initiating PrEP were invited to participate in a study exploring men’s HIV prevention needs and reasons for initiating PrEP. An in-depth interview guide, developed using the Network-Individual-Resources model (NIRM), explored men’s perceived HIV acquisition risk, prevention needs, and preferences for PrEP initiation. Interviews were conducted by a trained interviewer in isiXhosa or English, audio-recorded and transcribed. Thematic analysis was used, guided by the NIRM to generate findings. Results Twenty-two men (age range 18–57 years) initiated PrEP and consented to study participation. Men reported elevated HIV acquisition risk associated with alcohol use and condom-less sex with multiple partners as facilitators driving PrEP initiation. They anticipated social support from family members, their main sexual partner and close friends for their PrEP use, and discussed other men as important sources of support for PrEP initiation. Nearly all men expressed positive views of people using PrEP. Participants believed HIV testing would be a barrier for men interested in accessing PrEP. Men recommended that access to PrEP be convenient, rapid, and community-based (i.e., not clinic-based). Discussion Self-perceived risk for HIV acquisition was a major facilitator for men’s PrEP initiation. Although men expressed positive perceptions of PrEP users, they noted that HIV testing may be a barrier to PrEP initiation. Finally, men recommended convenient access points to facilitate PrEP initiation and sustained use. Gender-responsive interventions tailored to men’s needs, wants, and voices will facilitate their uptake of HIV prevention services, and help to end the HIV epidemic.

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Section: Methodsmentioning

confidence: 99%

What motivated men to start PrEP? A cross-section of men starting PrEP in Buffalo city municipality, South Africa

et al. 2023

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“…This study was nested within the Community PrEP Study (CPS) (36,37). CPS aimed to leverage community-based platforms to increase access and adherence to PrEP among young women in two high HIV burden communities in Eastern Cape Province, South Africa (Fig.…”

Section: Study Settingmentioning

confidence: 99%

What motivated men to start PrEP? A cross-section of men starting PrEP in Buffalo City Municipality, South Africa

Smith

Daniels

Bekker

et al. 2022

Preprint

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Background Compared to women, South African men are less likely to know their HIV status (78% vs 89%), have suppressed viral loads (82% vs 90%), or access HIV prevention services. To achieve epidemic control where heterosexual sexual behavior drives transmission, interventions to improve the uptake of HIV testing services (HTS) and prevention services must also target cis-gendered, heterosexual men. There is limited understanding of these men’s needs and wants with regards to accessing pre-exposure prophylaxis (PrEP). Methods Adult men (≥ 18 years) from a peri-urban community in Buffalo City Municipality were offered community-based HTS. Those who received a negative HIV test result were offered community-based, same-day oral PrEP initiation. Men initiating PrEP were invited to participate in a study exploring men’s HIV prevention needs and reasons for initiating PrEP. An in-depth interview guide, developed using the Network-Individual-Resources model (NIRM), explored men’s perceived HIV acquisition risk, prevention needs, and preferences for PrEP initiation. Interviews were conducted by a trained interviewer in isiXhosa or English, audio-recorded and transcribed. Thematic analysis was used, guided by the NIRM to generate findings. Results Twenty-two men (age range 18–57 years) initiated PrEP and consented to study participation. Men reported elevated HIV acquisition risk associated with alcohol use and condom-less sex with multiple partners as facilitators driving PrEP initiation. They anticipated social support from family members, their main sexual partner and close friends for their PrEP use, and discussed other men as important sources of support for PrEP initiation. Nearly all men expressed positive views of people using PrEP. Participants believed HIV testing would be a barrier for men interested in accessing PrEP. Men recommended that access to PrEP be convenient, rapid, and community-based (i.e., not clinic-based). Discussion Self-perceived risk for HIV acquisition was a major facilitator for men’s PrEP initiation. Although men expressed positive perceptions of PrEP users, they noted that HIV testing may be a barrier to PrEP initiation. Finally, men recommended convenient access points to facilitate PrEP initiation and sustained use. Gender-responsive interventions tailored to men’s needs, wants, and voices will facilitate their uptake of HIV prevention services, and help to end the HIV epidemic.

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“…Theme discrepancies were resolved by agreement during research team discussions. The usability survey was analyzed in STATA using descriptive statistics (Medina-Marino et al, 2022). A convergent analytical approach was applied to compare results from the focus group and survey to finalize intervention components and delivery considerations (Poteat et al, 2020; Teo et al, 2020).…”

Section: Methodsmentioning

confidence: 99%

Developing the Speaking Out and Allying Relationships Intervention on Videoconference for HIV-Positive GBMSM in Eastern Cape, South Africa

Daniels,

Peters,

Portle

et al. 2023

Am J Mens Health

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In South Africa, HIV prevalence for gay, bisexual, and men who have sex with men (GBMSM) is as high as 49.5%, yet only 25.7% are taking treatment, resulting in transmission risk between partners and the need for dyadic interventions for men in relationships. Through our preliminary research, we identified the evidence-based intervention Healthy Relationships (HR)—an HIV risk assessment and status disclosure intervention for those in relationships—to be tailored into videoconference format for partnered HIV-positive GBMSM in South Africa. The HR adaptation, called SOAR (Speaking Out & Allying Relationships), applied a human-centered design approach. In-depth interviews were conducted with HIV-positive GBMSM ( N = 15) to refine intervention preferences with results used to establish a beta SOAR. A trained interventionist conducted SOAR functionality ( n = 6) and usability ( n = 7) tests with separate invited groups composed of the original participants interviewed. Field logs, focus group discussions, and a study-specific preference survey were administered. Thematic analysis and descriptive statistics were completed with a convergent analytical approach used to understand usability. Overall experience of GBMSM in SOAR was good (69%) or excellent (31%). More than half of the participants (61%) rated using videoconferencing for SOAR as good, with 38% rating it as fair. All participants stated that SOAR was understandable and satisfactory with willingness to recommend it to other GBMSM. This adaptation approach was effective, and the resultant SOAR intervention has the potential to improve individual coping and HIV communication skills with partners to engage with biomedical prevention and in turn support GBMSM couples.

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Acceptability and feasibility of leveraging community‐based HIV counselling and testing platforms for same‐day oral PrEP initiation among adolescent girls and young women in Eastern Cape, South Africa

Cited by 20 publications

References 61 publications

What motivated men to start PrEP? A cross-section of men starting PrEP in Buffalo city municipality, South Africa

What motivated men to start PrEP? A cross-section of men starting PrEP in Buffalo city municipality, South Africa

What motivated men to start PrEP? A cross-section of men starting PrEP in Buffalo City Municipality, South Africa

Developing the Speaking Out and Allying Relationships Intervention on Videoconference for HIV-Positive GBMSM in Eastern Cape, South Africa

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