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.
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.
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DOI：
10.1371/journal.pone.0264808
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发表时间：
2022
期刊：
影响因子：
3.7
通讯作者：
Mathews C
中科院分区：
文献类型：
--
作者：
Nicol E;Ramraj T;Hlongwa M;Basera W;Jama N;Lombard C;McClinton-Appollis T;Govindasamy D;Pass D;Funani N;Aheron S;Paredes-Vincent A;Drummond J;Cheyip M;Dladla S;Bedford J;Mathews C
暴露前预防（PrEP）是一种有效的预防干预措施，可用于控制艾滋病毒发病率，特别是在艾滋病毒风险增加的人群中，如青春期女孩和年轻女性（AGYW）和青春期男孩和年轻男性（ABYM）。在南非，在不同的服务提供点（仅以设施为基础、仅以学校为基础、仅以社区为基础以及学校-设施和社区-设施混合模式）采用了各种提供PrEP的方法，以克服与个人、结构和卫生系统相关的障碍相关的挑战，这些障碍可能阻碍这些人群获得和接受PrEP。然而，很少有人知道如何优化PrEP的实施和业务战略，以实现高质量服务的高持续吸收AGYW和ABYM。本研究旨在确定有效和可行的PrEP护理模式，以改善AGYW和ABYM之间的PrEP吸收，延续和依从性。将在南非夸祖鲁-纳塔尔uMgungundlovu区的22个服务提供点进行一项连续的解释性混合方法研究。我们将招募600名艾滋病毒阴性、性活跃、高危、AGYW（15-24岁）和ABYM（15-35岁）。我们将在1个月、4个月和7个月时对入组的参与者进行随访，以确定是否继续和坚持PrEP。在1个月内启动PrEP，ii.未在1个月内启动PrEP，iii.在4/7个月时继续PrEP和iv.在4/7个月时没有继续PrEP）和来自四个组中每个组的48次深入访谈（每组12次）。还将与从事艾滋病毒方案工作的利益攸关方进行12次关键的知情人访谈。将使用卡方/Fishers精确检验或t检验/Mann Whitney检验评估按PrEP启动和各种服务提供模式分层的人口统计学特征之间的关联。一般归纳法将用于分析定性数据。该方案已获得南非医学研究理事会健康研究伦理委员会（EC 051 -11/2020）的批准。研究结果将传达给研究人群，并将结果提交给利益相关者以及适当的地方和国际会议。产出还将包括一份政策简报、同行评议的期刊文章和通过研究学位进行研究能力建设。
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. 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. 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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3.7
作者：
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