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Feasibility and acceptability of peer-delivered HIV self-testing and PrEP for young women in Kampala, Uganda
BACKGROUND: Adolescent girls and young women (AGYW) account for 29% of new HIV infections in Uganda despite representing just 10% of the population. Peer support improves AGYW linkage to HIV care and medication adherence. We evaluated the feasibility and acceptability of peer delivered HIV self-test...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10273744/ https://www.ncbi.nlm.nih.gov/pubmed/37322510 http://dx.doi.org/10.1186/s12889-023-16081-0 |
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author | Nakalega, Rita Mukiza, Nelson Menge, Robert Kizito, Samuel Babirye, Juliet Allen Kuteesa, Cynthia Ndikuno Mawanda, Denis Mulumba, Emmie Nabukeera, Josephine Ggita, Joseph Nakanjako, Lydia Akello, Carolyne Mirembe, Brenda Gati Lukyamuzi, Zubair Nakaye, Catherine Kataike, Hajira Maena, Joel Etima, Juliane Nabunya, Hadijah Kalule Biira, Florence Nagawa, Christine Heffron, Renee Celum, Connie Gandhi, Monica Mujugira, Andrew |
author_facet | Nakalega, Rita Mukiza, Nelson Menge, Robert Kizito, Samuel Babirye, Juliet Allen Kuteesa, Cynthia Ndikuno Mawanda, Denis Mulumba, Emmie Nabukeera, Josephine Ggita, Joseph Nakanjako, Lydia Akello, Carolyne Mirembe, Brenda Gati Lukyamuzi, Zubair Nakaye, Catherine Kataike, Hajira Maena, Joel Etima, Juliane Nabunya, Hadijah Kalule Biira, Florence Nagawa, Christine Heffron, Renee Celum, Connie Gandhi, Monica Mujugira, Andrew |
author_sort | Nakalega, Rita |
collection | PubMed |
description | BACKGROUND: Adolescent girls and young women (AGYW) account for 29% of new HIV infections in Uganda despite representing just 10% of the population. Peer support improves AGYW linkage to HIV care and medication adherence. We evaluated the feasibility and acceptability of peer delivered HIV self-tests (HIVST) and oral pre-exposure prophylaxis (PrEP) to young women in Uganda. METHODS: Between March and September 2021, we conducted a pilot study of 30 randomly selected young women, aged 18–24 years, who had received oral PrEP for at least three months, but had suboptimal adherence as measured by urine tenofovir testing (< 1500 ng/ml). Participants were offered daily oral PrEP and attended clinic visits three and six months after enrollment. Between clinic visits, participants were visited monthly by trained peers who delivered HIVST and PrEP. Feasibility and acceptability of peer-delivered PrEP and HIVST (intervention) were measured by comparing actual versus planned intervention delivery and product use. We conducted two focus groups with young women, and five in-depth interviews with peers and health workers to explore their experiences with intervention delivery. Qualitative data were analyzed using thematic analysis. RESULTS: At baseline, all 30 enrolled young women (median age 20 years) accepted peer-delivered PrEP and HIVST. Peer delivery visit completion was 97% (29/30) and 93% (28/30) at three and six months, respectively. The proportion of participants with detectable tenofovir in urine was 93% (27/29) and 57% (16/28) at months three and six, respectively. Four broad themes emerged from the qualitative data: (1) Positive experiences of peer delivered HIVST and PrEP; (2) The motivating effect of peer support; (3) Perceptions of female controlled HIVST and PrEP; and (4) Multi-level barriers to HIVST and PrEP use. Overall, peer delivery motivated young women to use HIVST and PrEP and encouraged persistence on PrEP by providing non-judgmental client-friendly services and adherence support. CONCLUSION: Peer delivery of HIVST and oral PrEP was feasible and acceptable to this sample of young women with suboptimal PrEP adherence in Uganda. Future larger controlled studies should evaluate its effectiveness among African AGWY. |
format | Online Article Text |
id | pubmed-10273744 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-102737442023-06-17 Feasibility and acceptability of peer-delivered HIV self-testing and PrEP for young women in Kampala, Uganda Nakalega, Rita Mukiza, Nelson Menge, Robert Kizito, Samuel Babirye, Juliet Allen Kuteesa, Cynthia Ndikuno Mawanda, Denis Mulumba, Emmie Nabukeera, Josephine Ggita, Joseph Nakanjako, Lydia Akello, Carolyne Mirembe, Brenda Gati Lukyamuzi, Zubair Nakaye, Catherine Kataike, Hajira Maena, Joel Etima, Juliane Nabunya, Hadijah Kalule Biira, Florence Nagawa, Christine Heffron, Renee Celum, Connie Gandhi, Monica Mujugira, Andrew BMC Public Health Research BACKGROUND: Adolescent girls and young women (AGYW) account for 29% of new HIV infections in Uganda despite representing just 10% of the population. Peer support improves AGYW linkage to HIV care and medication adherence. We evaluated the feasibility and acceptability of peer delivered HIV self-tests (HIVST) and oral pre-exposure prophylaxis (PrEP) to young women in Uganda. METHODS: Between March and September 2021, we conducted a pilot study of 30 randomly selected young women, aged 18–24 years, who had received oral PrEP for at least three months, but had suboptimal adherence as measured by urine tenofovir testing (< 1500 ng/ml). Participants were offered daily oral PrEP and attended clinic visits three and six months after enrollment. Between clinic visits, participants were visited monthly by trained peers who delivered HIVST and PrEP. Feasibility and acceptability of peer-delivered PrEP and HIVST (intervention) were measured by comparing actual versus planned intervention delivery and product use. We conducted two focus groups with young women, and five in-depth interviews with peers and health workers to explore their experiences with intervention delivery. Qualitative data were analyzed using thematic analysis. RESULTS: At baseline, all 30 enrolled young women (median age 20 years) accepted peer-delivered PrEP and HIVST. Peer delivery visit completion was 97% (29/30) and 93% (28/30) at three and six months, respectively. The proportion of participants with detectable tenofovir in urine was 93% (27/29) and 57% (16/28) at months three and six, respectively. Four broad themes emerged from the qualitative data: (1) Positive experiences of peer delivered HIVST and PrEP; (2) The motivating effect of peer support; (3) Perceptions of female controlled HIVST and PrEP; and (4) Multi-level barriers to HIVST and PrEP use. Overall, peer delivery motivated young women to use HIVST and PrEP and encouraged persistence on PrEP by providing non-judgmental client-friendly services and adherence support. CONCLUSION: Peer delivery of HIVST and oral PrEP was feasible and acceptable to this sample of young women with suboptimal PrEP adherence in Uganda. Future larger controlled studies should evaluate its effectiveness among African AGWY. BioMed Central 2023-06-16 /pmc/articles/PMC10273744/ /pubmed/37322510 http://dx.doi.org/10.1186/s12889-023-16081-0 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Nakalega, Rita Mukiza, Nelson Menge, Robert Kizito, Samuel Babirye, Juliet Allen Kuteesa, Cynthia Ndikuno Mawanda, Denis Mulumba, Emmie Nabukeera, Josephine Ggita, Joseph Nakanjako, Lydia Akello, Carolyne Mirembe, Brenda Gati Lukyamuzi, Zubair Nakaye, Catherine Kataike, Hajira Maena, Joel Etima, Juliane Nabunya, Hadijah Kalule Biira, Florence Nagawa, Christine Heffron, Renee Celum, Connie Gandhi, Monica Mujugira, Andrew Feasibility and acceptability of peer-delivered HIV self-testing and PrEP for young women in Kampala, Uganda |
title | Feasibility and acceptability of peer-delivered HIV self-testing and PrEP for young women in Kampala, Uganda |
title_full | Feasibility and acceptability of peer-delivered HIV self-testing and PrEP for young women in Kampala, Uganda |
title_fullStr | Feasibility and acceptability of peer-delivered HIV self-testing and PrEP for young women in Kampala, Uganda |
title_full_unstemmed | Feasibility and acceptability of peer-delivered HIV self-testing and PrEP for young women in Kampala, Uganda |
title_short | Feasibility and acceptability of peer-delivered HIV self-testing and PrEP for young women in Kampala, Uganda |
title_sort | feasibility and acceptability of peer-delivered hiv self-testing and prep for young women in kampala, uganda |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10273744/ https://www.ncbi.nlm.nih.gov/pubmed/37322510 http://dx.doi.org/10.1186/s12889-023-16081-0 |
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