Design of an Implant for Long-Acting HIV Pre-Exposure Prophylaxis: Input from South African Health Care Providers
| Autor: | Millicent Atujuna, Shannon O'Rourke, Linda-Gail Bekker, Ariane van der Straten, Alexandra M. Minnis, Elizabeth T. Montgomery, Khatija Ahmed, Emily A Krogstad |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Community education Anti-HIV Agents Health Personnel education Human immunodeficiency virus (HIV) Black People Context (language use) HIV Infections medicine.disease_cause Interviews as Topic 03 medical and health sciences Pre-exposure prophylaxis South Africa 0302 clinical medicine Nursing Health care Medicine Humans 030212 general & internal medicine Drug Implants 030505 public health business.industry Clinical and Epidemiologic Research Public Health Environmental and Occupational Health Social environment Middle Aged Infectious Diseases Female Pre-Exposure Prophylaxis Implant 0305 other medical science Contraceptive implant business |
| Zdroj: | AIDS patient care and STDs. 33(4) |
| ISSN: | 1557-7449 |
| Popis: | Implants are in the pre-clinical stage for long-acting HIV pre-exposure prophylaxis (PrEP), with an opportunity to solicit end-users' feedback early in development. Health care providers (HCPs) have been key gatekeepers for contraceptive implant uptake, and uniquely understand both technical considerations and the social context of use. Given their influential role, we gathered South African HCP perspectives on contraceptive implant implementation and features of PrEP implant prototypes that may influence future provider and patient acceptability. We conducted in-depth interviews with 30 HCPs (20 nurses and 10 doctors) in Cape Town and Soshanguve, South Africa. Interviews were conducted by a bioengineer and later transcribed, coded, and analyzed for key themes. HCPs described health system barriers such as understaffed clinics and inadequate training on contraceptive implant removal as major influences to their PrEP implant design preferences. They preferred a PrEP implant that is long lasting (>6 months) to minimize patient-clinic interactions, biodegradable to avoid need for removal, and flexible (but still palpable in case of removal). Commenting on negative experiences with contraceptive implant rollout, they recommended prioritizing both HCP and community education on the PrEP implant, with emphasis on expected side effects, and planning ahead for adequate training of HCPs before rollout. Challenges experienced with past contraceptive implant rollout may taint perspectives on future PrEP implants and must be carefully considered during product development and planning for clinical studies. Particular consideration should be given to the health system context of future distribution, including staff who would be providing and monitoring implants. |
| Databáze: | OpenAIRE |
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