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Reaching at-risk women for PrEP delivery: What can we learn from clinical trials in sub-Saharan Africa?
INTRODUCTION: ARV-based pre-exposure prophylaxis (PrEP) has the potential to avert many new HIV infections, yet little is known about how to reach women at high risk for HIV infection and motivate them to initiate PrEP. Clinical trials have succeeded in recruiting at-risk participants, evidenced by...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6588242/ https://www.ncbi.nlm.nih.gov/pubmed/31226165 http://dx.doi.org/10.1371/journal.pone.0218556 |
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author | Stankevitz, Kayla Schwartz, Katie Hoke, Theresa Li, Yixuan Lanham, Michele Mahaka, Imelda Mullick, Saiqa |
author_facet | Stankevitz, Kayla Schwartz, Katie Hoke, Theresa Li, Yixuan Lanham, Michele Mahaka, Imelda Mullick, Saiqa |
author_sort | Stankevitz, Kayla |
collection | PubMed |
description | INTRODUCTION: ARV-based pre-exposure prophylaxis (PrEP) has the potential to avert many new HIV infections, yet little is known about how to reach women at high risk for HIV infection and motivate them to initiate PrEP. Clinical trials have succeeded in recruiting at-risk participants, evidenced by control arm HIV incidence ≥3% (defined by the World Health Organization as “substantial risk”). We examined experiences from HIV prevention trials to document recruitment strategies and identify practical, potentially effective strategies for reaching women in real-world PrEP delivery. METHODS: We conducted semi-structured qualitative phone interviews with 31 staff from five countries who had worked on one or more of seven ARV-based HIV prevention clinical trials. Questions explored recruitment strategies used to reach women at risk of HIV and to successfully communicate about PrEP (inclusive of oral and vaginal formulations). We structurally coded data in NVivo and analyzed codes to derive themes. We conducted results interpretation webinars with research and programmatic stakeholders to validate findings and develop recommendations. RESULTS: Clinical trial researchers employed a range of recruitment strategies to recruit at-risk women. They recommended engaging the local community and potential PrEP users via community events, meetings with gatekeepers, and use of community advisory boards; and they encouraged interpersonal communication like presentations in waiting rooms and door-to-door recruitment to address personal concerns and prevent misinformation. Participants also stressed the importance of addressing the challenges that already exist within the health system to create a more enabling environment and delivering positive messages through a variety of communication channels to normalize PrEP. CONCLUSIONS: Findings from this study provide important insights into potentially effective ways for countries currently rolling out oral PrEP to reach at-risk women with information about PrEP and promote uptake. |
format | Online Article Text |
id | pubmed-6588242 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-65882422019-06-28 Reaching at-risk women for PrEP delivery: What can we learn from clinical trials in sub-Saharan Africa? Stankevitz, Kayla Schwartz, Katie Hoke, Theresa Li, Yixuan Lanham, Michele Mahaka, Imelda Mullick, Saiqa PLoS One Research Article INTRODUCTION: ARV-based pre-exposure prophylaxis (PrEP) has the potential to avert many new HIV infections, yet little is known about how to reach women at high risk for HIV infection and motivate them to initiate PrEP. Clinical trials have succeeded in recruiting at-risk participants, evidenced by control arm HIV incidence ≥3% (defined by the World Health Organization as “substantial risk”). We examined experiences from HIV prevention trials to document recruitment strategies and identify practical, potentially effective strategies for reaching women in real-world PrEP delivery. METHODS: We conducted semi-structured qualitative phone interviews with 31 staff from five countries who had worked on one or more of seven ARV-based HIV prevention clinical trials. Questions explored recruitment strategies used to reach women at risk of HIV and to successfully communicate about PrEP (inclusive of oral and vaginal formulations). We structurally coded data in NVivo and analyzed codes to derive themes. We conducted results interpretation webinars with research and programmatic stakeholders to validate findings and develop recommendations. RESULTS: Clinical trial researchers employed a range of recruitment strategies to recruit at-risk women. They recommended engaging the local community and potential PrEP users via community events, meetings with gatekeepers, and use of community advisory boards; and they encouraged interpersonal communication like presentations in waiting rooms and door-to-door recruitment to address personal concerns and prevent misinformation. Participants also stressed the importance of addressing the challenges that already exist within the health system to create a more enabling environment and delivering positive messages through a variety of communication channels to normalize PrEP. CONCLUSIONS: Findings from this study provide important insights into potentially effective ways for countries currently rolling out oral PrEP to reach at-risk women with information about PrEP and promote uptake. Public Library of Science 2019-06-21 /pmc/articles/PMC6588242/ /pubmed/31226165 http://dx.doi.org/10.1371/journal.pone.0218556 Text en © 2019 Stankevitz et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Stankevitz, Kayla Schwartz, Katie Hoke, Theresa Li, Yixuan Lanham, Michele Mahaka, Imelda Mullick, Saiqa Reaching at-risk women for PrEP delivery: What can we learn from clinical trials in sub-Saharan Africa? |
title | Reaching at-risk women for PrEP delivery: What can we learn from clinical trials in sub-Saharan Africa? |
title_full | Reaching at-risk women for PrEP delivery: What can we learn from clinical trials in sub-Saharan Africa? |
title_fullStr | Reaching at-risk women for PrEP delivery: What can we learn from clinical trials in sub-Saharan Africa? |
title_full_unstemmed | Reaching at-risk women for PrEP delivery: What can we learn from clinical trials in sub-Saharan Africa? |
title_short | Reaching at-risk women for PrEP delivery: What can we learn from clinical trials in sub-Saharan Africa? |
title_sort | reaching at-risk women for prep delivery: what can we learn from clinical trials in sub-saharan africa? |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6588242/ https://www.ncbi.nlm.nih.gov/pubmed/31226165 http://dx.doi.org/10.1371/journal.pone.0218556 |
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