The PrEPARE Pretoria Project: protocol for a cluster-randomized factorial-design trial to prevent HIV with PrEP among adolescent girls and young women in Tshwane, South Africa

Autor: Courtney Peasant Bonner, Felicia A. Browne, Bronwyn Myers, Jacqueline Wanjiku Ndirangu, Wendee M. Wechsberg, Laura Nyblade, Khatija Ahmed, Brittni Nicole Howard, Ilene S. Speizer, Alexandra Minnis
Jazyk: angličtina
Rok vydání: 2020
Předmět:
medicine.medical_specialty
Adolescent
Sexual Behavior
Alcohol and drug use
Population
Psychological intervention
Stigma (botany)
HIV Infections
Clinic staff
law.invention
South Africa
03 medical and health sciences
Study Protocol
0302 clinical medicine
Condom
law
Gender-based violence
Young Women’s Health CoOp (YWHC)
medicine
Humans
030212 general & internal medicine
Adaptation
education
Health policy
Reproductive health
education.field_of_study
030505 public health
business.industry
lcsh:Public aspects of medicine
Public health
Public Health
Environmental and Occupational Health
HIV
Sexual and reproductive health (SRH)
lcsh:RA1-1270
Stigma
Pharmaceutical Preparations
Family medicine
Health Policy Project Stigma and Discrimination-reduction training (HPP S&D)
Female
Pre-Exposure Prophylaxis
Biostatistics
0305 other medical science
business
Zdroj: BMC Public Health
BMC Public Health, Vol 20, Iss 1, Pp 1-14 (2020)
ISSN: 1471-2458
Popis: Background Despite increased prevention efforts, HIV remains the leading cause of death among adolescent girls and young women in South Africa. Although research indicates important determinants of HIV acquisition at the individual and interpersonal levels, structural-level stigma and discrimination continue to be critical barriers to reaching and retaining this key population for HIV prevention and sexual and reproductive health services. Innovative and multilevel interventions are needed that can address the intersectional structural and gender issues that young women face, including stigma, alcohol and drug use, gender-based violence, and other risk factors when seeking health services. Oral pre-exposure prophylaxis (PrEP) taken daily has been found to be an effective biomedical HIV prevention tool. Testing a comprehensive gender-focused biobehavioral HIV prevention intervention that is inclusive of social ecological determinants, such as stigma and discrimination reduction in clinics, is critical for reducing HIV among adolescent girls and young women. Methods This project involves both a Community Collaborative Board and a Youth Advisory Board in helping to adapt the Young Women’s Health CoOp intervention and the Health Policy Project (HPP) Stigma and Discrimination (S&D) reduction training curriculum to the setting and population. This study uses a two-by-two factorial design with stratified randomization of 12 clinics, each with distinct catchment areas. The Young Women’s Health CoOp addresses substance use, sexual risk, violence prevention and sexual negotiation, condom demonstration, and problem solving with the following additions: knowledge of PrEP, the importance of PrEP adherence, and sexual and reproductive health. Adolescent girls and young women will be assessed with behavioral and biological measures at baseline, 3-, 6- and 9-month follow-up. The S&D reduction training is provided for all staff in the clinics randomized to this condition. Clinic staff will be surveyed at baseline, 4- and 8-month follow-up. We will recruit 900 AGYW from communities in the 12 clinic catchment areas. Discussion The study findings, if efficacious across the outcomes, will be incorporated into the gender-focused HIV prevention intervention toolkit and disseminated to inform multilevel prevention approaches. Trial registration ClinicalTrials.gov. Identifier: NCT04048551 (Recruiting). Registered: August 7, 2019 (Retrospectively registered).
Databáze: OpenAIRE
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