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Perspectives of South African youth in the development of an implant for HIV prevention

INTRODUCTION: Implants are a new dosage form in development for HIV pre‐exposure prophylaxis (PrEP) with potential for high adherence given that they are provider‐administered and are intended for long‐acting protection. Integrating end‐user preference into early stage product development may furthe...

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Autores principales: Krogstad, Emily A, Atujuna, Millicent, Montgomery, Elizabeth T, Minnis, Alexandra, Ndwayana, Sheily, Malapane, Tsholofelo, Shapley‐Quinn, Mary Kate, Manenzhe, Kgahlisho, Bekker, Linda‐Gail, van der Straten, Ariane
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6111144/
https://www.ncbi.nlm.nih.gov/pubmed/30152004
http://dx.doi.org/10.1002/jia2.25170
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author Krogstad, Emily A
Atujuna, Millicent
Montgomery, Elizabeth T
Minnis, Alexandra
Ndwayana, Sheily
Malapane, Tsholofelo
Shapley‐Quinn, Mary Kate
Manenzhe, Kgahlisho
Bekker, Linda‐Gail
van der Straten, Ariane
author_facet Krogstad, Emily A
Atujuna, Millicent
Montgomery, Elizabeth T
Minnis, Alexandra
Ndwayana, Sheily
Malapane, Tsholofelo
Shapley‐Quinn, Mary Kate
Manenzhe, Kgahlisho
Bekker, Linda‐Gail
van der Straten, Ariane
author_sort Krogstad, Emily A
collection PubMed
description INTRODUCTION: Implants are a new dosage form in development for HIV pre‐exposure prophylaxis (PrEP) with potential for high adherence given that they are provider‐administered and are intended for long‐acting protection. Integrating end‐user preference into early stage product development may further overcome challenges with future product uptake and adherence. Hence, we sought to optimize the design of a PrEP implant in early‐stage development by gathering opinions about implant attributes from potential end‐users in South Africa. METHODS: We conducted 14 focus group discussions (FGDs) with young women and men aged 18 to 24 in Cape Town and Soshanguve, South Africa, inviting participants into discussion as co‐designers. FGDs were homogenous by gender and previous implant experience. During FGDs, we showed prototype devices and followed a semi‐structured guide with questions on history of contraceptive implant use, preferences for physical characteristics of an implant, implant biodegradability, insertion process, participant‐driven ideas for implant design, and social adoption considerations. FGDs were facilitated in English, isiXhosa, Tswana, isiZulu, or Tsonga, audio‐recorded, transcribed into English, and qualitatively coded and analysed. RESULTS: In this qualitative sample of 105 youth (68 women and 37 men), 58 participants were from Soshanguve and 47 from Cape Town, and 23% had previously used contraceptive implants. Participants expressed preferences for several implant design features; specifically, longer duration (≥6 months) was more important to most participants than the size or number of devices implanted. A majority preferred a flexible versus stiff implant to minimize palpability, thereby increasing discreetness and comfort. Nearly all participants favoured a biodegradable implant to avoid removal and thus reduce clinic visits. Concerns about the implant centred on its possible side effects and the “plastic” look of the prototype displayed for demonstration. CONCLUSIONS: This study offers preliminary insights into an implant for HIV prevention that provides long‐lasting protection may be well received among young South Africans. Additionally, flexibility, discreetness, and biodegradability may increase acceptability of the implant. Such end–user feedback is being incorporated into current implant designs in the hope of creating an effective long‐acting PrEP product that is likely to achieve high uptake and adherence in target populations.
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spelling pubmed-61111442018-08-30 Perspectives of South African youth in the development of an implant for HIV prevention Krogstad, Emily A Atujuna, Millicent Montgomery, Elizabeth T Minnis, Alexandra Ndwayana, Sheily Malapane, Tsholofelo Shapley‐Quinn, Mary Kate Manenzhe, Kgahlisho Bekker, Linda‐Gail van der Straten, Ariane J Int AIDS Soc Research Articles INTRODUCTION: Implants are a new dosage form in development for HIV pre‐exposure prophylaxis (PrEP) with potential for high adherence given that they are provider‐administered and are intended for long‐acting protection. Integrating end‐user preference into early stage product development may further overcome challenges with future product uptake and adherence. Hence, we sought to optimize the design of a PrEP implant in early‐stage development by gathering opinions about implant attributes from potential end‐users in South Africa. METHODS: We conducted 14 focus group discussions (FGDs) with young women and men aged 18 to 24 in Cape Town and Soshanguve, South Africa, inviting participants into discussion as co‐designers. FGDs were homogenous by gender and previous implant experience. During FGDs, we showed prototype devices and followed a semi‐structured guide with questions on history of contraceptive implant use, preferences for physical characteristics of an implant, implant biodegradability, insertion process, participant‐driven ideas for implant design, and social adoption considerations. FGDs were facilitated in English, isiXhosa, Tswana, isiZulu, or Tsonga, audio‐recorded, transcribed into English, and qualitatively coded and analysed. RESULTS: In this qualitative sample of 105 youth (68 women and 37 men), 58 participants were from Soshanguve and 47 from Cape Town, and 23% had previously used contraceptive implants. Participants expressed preferences for several implant design features; specifically, longer duration (≥6 months) was more important to most participants than the size or number of devices implanted. A majority preferred a flexible versus stiff implant to minimize palpability, thereby increasing discreetness and comfort. Nearly all participants favoured a biodegradable implant to avoid removal and thus reduce clinic visits. Concerns about the implant centred on its possible side effects and the “plastic” look of the prototype displayed for demonstration. CONCLUSIONS: This study offers preliminary insights into an implant for HIV prevention that provides long‐lasting protection may be well received among young South Africans. Additionally, flexibility, discreetness, and biodegradability may increase acceptability of the implant. Such end–user feedback is being incorporated into current implant designs in the hope of creating an effective long‐acting PrEP product that is likely to achieve high uptake and adherence in target populations. John Wiley and Sons Inc. 2018-08-27 /pmc/articles/PMC6111144/ /pubmed/30152004 http://dx.doi.org/10.1002/jia2.25170 Text en © 2018 RTI International. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of the International AIDS Society This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Articles
Krogstad, Emily A
Atujuna, Millicent
Montgomery, Elizabeth T
Minnis, Alexandra
Ndwayana, Sheily
Malapane, Tsholofelo
Shapley‐Quinn, Mary Kate
Manenzhe, Kgahlisho
Bekker, Linda‐Gail
van der Straten, Ariane
Perspectives of South African youth in the development of an implant for HIV prevention
title Perspectives of South African youth in the development of an implant for HIV prevention
title_full Perspectives of South African youth in the development of an implant for HIV prevention
title_fullStr Perspectives of South African youth in the development of an implant for HIV prevention
title_full_unstemmed Perspectives of South African youth in the development of an implant for HIV prevention
title_short Perspectives of South African youth in the development of an implant for HIV prevention
title_sort perspectives of south african youth in the development of an implant for hiv prevention
topic Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6111144/
https://www.ncbi.nlm.nih.gov/pubmed/30152004
http://dx.doi.org/10.1002/jia2.25170
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