Cost-Effectiveness of Interventions to Prevent HIV Acquisition

Garnett, Geoff P.; Krishnaratne, Shari; Harris, Kate Lockwood; Hallett, Timothy B.; Santos, Michael A.; Enstone, Joanne; Hensen, Bernadette; Dallabetta, Gina; Revill, Paul; Gregson, Simon; Hargreaves, James

doi:10.1596/978-1-4648-0524-0_ch7

Cited by 13 publications

(9 citation statements)

References 76 publications

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“…This is despite highly e cacious and cost-effective HIV prevention tools. These include HIV point-of-care tests (POCT) and self-tests; the use of daily oral tenofovir/emtricitabine for Pre-Exposure Prophylaxis (PrEP), which can reduce the risk of acquiring HIV by up to 90%; voluntary medical male circumcision that reduces the risk for men of acquiring HIV by 60%; and HIV treatment with antiretroviral therapy (ART) that reduces mortality and eliminates onward transmission of HIV to sexual partners [2][3][4]. This failure to arrest the HIV epidemic is partly a result of the disparity between the vulnerability of subpopulations to HIV and their use of HIV prevention tools.…”

Section: Introductionmentioning

confidence: 99%

Thetha Nami : Participatory development of a peer-navigator intervention to deliver biosocial HIV prevention for adolescents and youth in rural South Africa

Shahmanesh

Okesola

Chimbindi

et al. 2021

Preprint

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Background: Despite effective biomedical tools, HIV remains the largest cause of morbidity/mortality in South Africa – especially among adolescents and young people. We used community-based participatory research (CBPR) informed by principles of social justice, to develop a peer-led biosocial intervention for HIV prevention in rural KwaZulu-Natal (KZN). Methods: Between March 2018 and September 2019 we used CBPR to iteratively co-create and contextually adapt a biosocial peer-led intervention to support HIV prevention. Men and women aged 18-30 years were selected by community leaders of 21 intervention implementation areas (izigodi) and underwent 20 weeks of training as peer-navigators. We synthesised quantitative and qualitative data collected during a 2016-2018 study into 17 vignettes illustrating the local drivers of HIV. During three participatory intervention development workshops and community mapping sessions, the peer-navigators critically engaged with vignettes, brainstormed solutions and mapped the components to their own izigodi. The intervention components were plotted to a Theory of Change which, following a six-month pilot and process evaluation, the peer-navigators refined. The intervention will be evaluated in a randomised controlled trial (NCT04532307).Results: Following written and oral assessments, 57 of the 108 initially selected participated in two workshops to discuss the vignettes and co-create the Thetha Nami (`talk to me’). The intervention. included peer-led health promotion to improve self-efficacy and demand for HIV prevention, referrals to social and educational resources, and aaccessible youth-friendly clinical services to improve uptake of HIV prevention. During the pilot the peer-navigators approached 6871 young people, of whom 6141 (89%) accepted health promotion and 438 linked to care. During semi-structured interviews peer-navigators described the appeal of providing sexual health information to peers of a similar age and background but wanted to provide more than just “onward referral”. In the third participatory workshop 54 peer-navigators refined the Thetha Nami intervention to add three components structured assessment tool to tailor health promotion and referrals; safe spaces and community advocacy to create an enabling environment; peer-mentorship and navigation of resources to improve retention in HIV prevention. Conclusion: Local youth were able to use evidence to develop a contextually adapted peer-led intervention to deliver biosocial HIV prevention.

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Section: Introductionmentioning

confidence: 99%

Thetha Nami : Participatory development of a peer-navigator intervention to deliver biosocial HIV prevention for adolescents and youth in rural South Africa

Shahmanesh

Okesola

Chimbindi

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

“…4: Community entry and mapping the intervention components to the areas: Between November 2018 and February 2019 the peer navigators worked with the social scientists and professional nurses to successfully enter and map all 21 izigodis and conducted a second workshop to harmonize activities (November 2018). Peer navigators were introduced to all the schools in 20 areas (91%) and identi ed adult youth champions in 20 areas (91%).…”

mentioning

confidence: 99%

Thetha Nami: Participatory development of a peer-navigator intervention to deliver biosocial HIV prevention for adolescents and young men and women in rural South Africa

Shahmanesh

Okesola

Chimbindi

et al. 2020

Preprint

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BackgroundDespite effective biomedical tools, adolescents and young men and women carry the dual burden of high HIV incidence and high morbidity/mortality in South Africa. We integrated community-based participatory research (CBPR) with biomedical interventions to develop a peer-led biosocial intervention for HIV care and prevention in young people living in rural KwaZulu-Natal (KZN).MethodsBetween March 2018 and September 2019 we used CBPR to iteratively co-create and contextually adapt a biosocial peer-led intervention to support HIV prevention. Men and women aged 18–30 years were selected by community leaders of 21 intervention implementation areas (izigodi) and underwent 20 weeks of training as peer-navigators. We synthesised quantitative and qualitative data collected between 2016 and 2018 into 17 vignettes illustrating the local drivers of HIV. During two participatory intervention development workshops and community mapping, the peer-navigators discussed the vignettes in small groups, brainstormed solutions and mapped the components to their own izigodi. The intervention components were plotted to a Theory of Change (ToC). Following a six-month pilot, the peer-navigators used process evaluation data and experience to refine the ToC in a third workshop.ResultsFollowing written and oral assessments 57 of the 108 initially selected participated in the two workshops to discuss the vignettes and co-create the Thetha Nami (talk to me) intervention. During the pilot the peer-navigators approached 6871 young people, of whom 6141 (89%) accepted health promotion and 438 linked to care. During semi-structured interviews peer-navigators described the appeal of providing sexual health information to peers of a similar age and background but wanted to provide more than just “onward referral”. In the third participatory workshop 54 peer-navigators refined the Thetha Nami intervention to include:· Structured assessment tool to tailor support.· Safe spaces and community advocacy to create an enabling environment for HIV prevention.· Peer-led sexual health promotion to improve self-efficacy and demand for HIV prevention.· Accessible youth-friendly clinical services to improve uptake of HIV prevention.· Peer-mentorship to navigate resources and improve retention in HIV prevention.ConclusionLocal youth were able to use evidence to develop a contextually adapted peer-led intervention to deliver biosocial HIV prevention and care.

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“…This pharmacological regimen is used prior to sexual activity in a group at a risk of infection, and the best known is the combination regimen of two reverse transcriptase inhibitors, Truvada [1]. According to a recent study, PrEP is routinely used for two and a half years, effectively preventing HIV infection [2]. Needless to mention, it is not to protect against sexually transmitted diseases and infectious diseases other than HIV.…”

Section: Introductionmentioning

confidence: 99%

Persistence of Human Immunodeficiency Virus and Vaccine Development

Yamamoto¹

2019

JIDTM

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Cost-Effectiveness of Interventions to Prevent HIV Acquisition

Cited by 13 publications

References 76 publications

Thetha Nami : Participatory development of a peer-navigator intervention to deliver biosocial HIV prevention for adolescents and youth in rural South Africa

Thetha Nami : Participatory development of a peer-navigator intervention to deliver biosocial HIV prevention for adolescents and youth in rural South Africa

Thetha Nami: Participatory development of a peer-navigator intervention to deliver biosocial HIV prevention for adolescents and young men and women in rural South Africa

Persistence of Human Immunodeficiency Virus and Vaccine Development

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