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Implementation of PrEP in SRH Settings

This study focuses on the implementation of Pre-Exposure Prophylaxis (PrEP) in sexual and reproductive health (SRH) settings, highlighting challenges and strategies for engaging the target population. The study aims to overcome barriers like limited time, stigma, and transportation costs through male engagement, retention strategies, and continuous engagement via technology.

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Implementation of PrEP in SRH Settings

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  1. IMPLEMETNATION OF PrEP IN SRH SETTINGS(OR CLIMBING A MOUNTAIN) Elizabeth Anne Bukusi Chief Research Officer Kenya Medical Institute Research Professor , University of Washington

  2. COI • Funding for implementation research for PrEP among young women by • USAID • NIH

  3. Kisumu City

  4. Situation Analysis Source: Kenya HIV County Profiles 2014 National AIDS Control Council

  5. The Kenyan HIV Epidemic National AIDS Control Council

  6. HIV prevalence among 15-24 year olds in Kenya

  7. THE TARGET POPULATION

  8. LEADERSHIP

  9. HEALTH SYSTEMS ENGAGMENT

  10. COMMUNITY

  11. Potential Barriers • Time off work /school may be limited • Fear of stigma associated with disease under study • Transportation cost • Household responsibilities-taking care of children, older family members • School

  12. MALE ENGAGEMENT

  13. Retention strategies • Appropriate and clear PrEP messaging • Friendly clinic environment • Fast tracking and short waiting time • Friendly and flexible staff • Wi-Fi • Integrating other clinic services to save on time • Phone call reminders • Support group • Continuous engagement via text and social media

  14. The POWER STUDY – Kisumu Kenya -2018 • Age 16-25 • Able and willing to provide written informed consent • Recently sexually active (defined as having had vaginal intercourse at least once in the previous three months) • HIV uninfected based on negative HIV rapid tests, on the date of enrollment

  15. STI PREVALENCE

  16. Challenges • Mobilization • Client- stigma, pill burden, disclosure, PrEP and condom use • Community- Myths and misconceptions about PrEP

  17. Challenges • Integration • Long waiting time- in other services • Space- shared; limited privacy and confidentiality • Nursing staff- negative attitude. Additional work, staff rotation • Laboratory- staff attitude • Pharmacy- staff rotation

  18. Success • Numbers enrolled and referring friends and networks • We are penetrating the community and increasing PrEP awareness • Some initial refusers have taken up PrEP

  19. It will not be easy, but it will be worth it

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