Strengthening health system's capacity for pre-exposure prophylaxis for adolescent girls and young women and adolescent boys and young men in South Africa (SHeS'Cap-PrEP): Protocol for a mixed methods study in KwaZulu-Natal, South Africa.

<h4>Introduction</h4>Pre-exposure prophylaxis (PrEP) is an effective prevention intervention that can be used to control HIV incidence especially among people who are at increased risk for HIV such as adolescent girls and young women (AGYW) and adolescent boys and young men (ABYM). In So...

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Main Authors: Edward Nicol, Trisha Ramraj, Mbuzeleni Hlongwa, Wisdom Basera, Ngcwalisa Jama, Carl Lombard, Tracy McClinton-Appollis, Darshini Govindasamy, Desiree Pass, Noluntu Funani, Sarah Aheron, Ariana Paredes-Vincent, Jennifer Drummond, Mireille Cheyip, Sibongile Dladla, Jason Bedford, Cathy Mathews
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2022-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0264808&type=printable
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author Edward Nicol
Trisha Ramraj
Mbuzeleni Hlongwa
Wisdom Basera
Ngcwalisa Jama
Carl Lombard
Tracy McClinton-Appollis
Darshini Govindasamy
Desiree Pass
Noluntu Funani
Sarah Aheron
Ariana Paredes-Vincent
Jennifer Drummond
Mireille Cheyip
Sibongile Dladla
Jason Bedford
Cathy Mathews
author_facet Edward Nicol
Trisha Ramraj
Mbuzeleni Hlongwa
Wisdom Basera
Ngcwalisa Jama
Carl Lombard
Tracy McClinton-Appollis
Darshini Govindasamy
Desiree Pass
Noluntu Funani
Sarah Aheron
Ariana Paredes-Vincent
Jennifer Drummond
Mireille Cheyip
Sibongile Dladla
Jason Bedford
Cathy Mathews
author_sort Edward Nicol
collection DOAJ
description <h4>Introduction</h4>Pre-exposure prophylaxis (PrEP) is an effective prevention intervention that can be used to control HIV incidence especially among people who are at increased risk for HIV such as adolescent girls and young women (AGYW) and adolescent boys and young men (ABYM). In South Africa, various approaches of delivering PrEP have been adopted at different service delivery points (facility-based only, school-based only, community-based only and hybrid school-facility and community-facility models) to overcome challenges associated with individual, structural, and health systems related barriers that may hinder access to and uptake of PrEP among these populations. However, little is known about how to optimize PrEP implementation and operational strategies to achieve high sustained uptake of good quality services for AGYW and ABYM. This study aims to identify effective and feasible PrEP models of care for improving PrEP uptake, continuation, and adherence among AGYW and ABYM.<h4>Methods and analysis</h4>A sequential explanatory mixed-methods study will be conducted in 22 service delivery points (SDPs) in uMgungundlovu district, KwaZulu-Natal, South Africa. We will recruit 600 HIV negative, sexually active, high risk, AGYW (aged 15-24 years) and ABYM (aged 15-35 years). Enrolled participants will be followed up at 1-, 4- and 7-months to determine continuation and adherence to PrEP. We will conduct two focus group discussions (with 8 participants in each group) across four groups (i. Initiated PrEP within 1 month, ii. Did not initiate PrEP within 1 month, iii. Continued PrEP at 4/7 months and iv. Did not continue PrEP at 4/7 months) and 48 in-depth interviews from each of the four groups (12 per group). Twelve key informant interviews with stakeholders working in HIV programs will also be conducted. Associations between demographic characteristics stratified by PrEP initiation and by various service-delivery models will be assessed using Chi-square/Fishers exact tests or t-test/Mann Whitney test. A general inductive approach will be used to analyze the qualitative data.<h4>Ethics and dissemination</h4>The protocol was approved by the South African Medical Research Council Health Research Ethics Committee (EC051-11/2020). Findings from the study will be communicated to the study population and results will be presented to stakeholders and at appropriate local and international conferences. Outputs will also include a policy brief, peer-reviewed journal articles and research capacity building through research degrees.
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spelling doaj-art-ef359dfb37334b5b8bd12a856eb1ed732025-08-20T03:46:21ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01173e026480810.1371/journal.pone.0264808Strengthening health system's capacity for pre-exposure prophylaxis for adolescent girls and young women and adolescent boys and young men in South Africa (SHeS'Cap-PrEP): Protocol for a mixed methods study in KwaZulu-Natal, South Africa.Edward NicolTrisha RamrajMbuzeleni HlongwaWisdom BaseraNgcwalisa JamaCarl LombardTracy McClinton-AppollisDarshini GovindasamyDesiree PassNoluntu FunaniSarah AheronAriana Paredes-VincentJennifer DrummondMireille CheyipSibongile DladlaJason BedfordCathy Mathews<h4>Introduction</h4>Pre-exposure prophylaxis (PrEP) is an effective prevention intervention that can be used to control HIV incidence especially among people who are at increased risk for HIV such as adolescent girls and young women (AGYW) and adolescent boys and young men (ABYM). In South Africa, various approaches of delivering PrEP have been adopted at different service delivery points (facility-based only, school-based only, community-based only and hybrid school-facility and community-facility models) to overcome challenges associated with individual, structural, and health systems related barriers that may hinder access to and uptake of PrEP among these populations. However, little is known about how to optimize PrEP implementation and operational strategies to achieve high sustained uptake of good quality services for AGYW and ABYM. This study aims to identify effective and feasible PrEP models of care for improving PrEP uptake, continuation, and adherence among AGYW and ABYM.<h4>Methods and analysis</h4>A sequential explanatory mixed-methods study will be conducted in 22 service delivery points (SDPs) in uMgungundlovu district, KwaZulu-Natal, South Africa. We will recruit 600 HIV negative, sexually active, high risk, AGYW (aged 15-24 years) and ABYM (aged 15-35 years). Enrolled participants will be followed up at 1-, 4- and 7-months to determine continuation and adherence to PrEP. We will conduct two focus group discussions (with 8 participants in each group) across four groups (i. Initiated PrEP within 1 month, ii. Did not initiate PrEP within 1 month, iii. Continued PrEP at 4/7 months and iv. Did not continue PrEP at 4/7 months) and 48 in-depth interviews from each of the four groups (12 per group). Twelve key informant interviews with stakeholders working in HIV programs will also be conducted. Associations between demographic characteristics stratified by PrEP initiation and by various service-delivery models will be assessed using Chi-square/Fishers exact tests or t-test/Mann Whitney test. A general inductive approach will be used to analyze the qualitative data.<h4>Ethics and dissemination</h4>The protocol was approved by the South African Medical Research Council Health Research Ethics Committee (EC051-11/2020). Findings from the study will be communicated to the study population and results will be presented to stakeholders and at appropriate local and international conferences. Outputs will also include a policy brief, peer-reviewed journal articles and research capacity building through research degrees.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0264808&type=printable
spellingShingle Edward Nicol
Trisha Ramraj
Mbuzeleni Hlongwa
Wisdom Basera
Ngcwalisa Jama
Carl Lombard
Tracy McClinton-Appollis
Darshini Govindasamy
Desiree Pass
Noluntu Funani
Sarah Aheron
Ariana Paredes-Vincent
Jennifer Drummond
Mireille Cheyip
Sibongile Dladla
Jason Bedford
Cathy Mathews
Strengthening health system's capacity for pre-exposure prophylaxis for adolescent girls and young women and adolescent boys and young men in South Africa (SHeS'Cap-PrEP): Protocol for a mixed methods study in KwaZulu-Natal, South Africa.
PLoS ONE
title Strengthening health system's capacity for pre-exposure prophylaxis for adolescent girls and young women and adolescent boys and young men in South Africa (SHeS'Cap-PrEP): Protocol for a mixed methods study in KwaZulu-Natal, South Africa.
title_full Strengthening health system's capacity for pre-exposure prophylaxis for adolescent girls and young women and adolescent boys and young men in South Africa (SHeS'Cap-PrEP): Protocol for a mixed methods study in KwaZulu-Natal, South Africa.
title_fullStr Strengthening health system's capacity for pre-exposure prophylaxis for adolescent girls and young women and adolescent boys and young men in South Africa (SHeS'Cap-PrEP): Protocol for a mixed methods study in KwaZulu-Natal, South Africa.
title_full_unstemmed Strengthening health system's capacity for pre-exposure prophylaxis for adolescent girls and young women and adolescent boys and young men in South Africa (SHeS'Cap-PrEP): Protocol for a mixed methods study in KwaZulu-Natal, South Africa.
title_short Strengthening health system's capacity for pre-exposure prophylaxis for adolescent girls and young women and adolescent boys and young men in South Africa (SHeS'Cap-PrEP): Protocol for a mixed methods study in KwaZulu-Natal, South Africa.
title_sort strengthening health system s capacity for pre exposure prophylaxis for adolescent girls and young women and adolescent boys and young men in south africa shes cap prep protocol for a mixed methods study in kwazulu natal south africa
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0264808&type=printable
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