CHARISMA – December 2017

CHARISMA supports efforts to: increase women’s agency to safely use ARV-based HIV prevention, to engage male partners in HIV prevention, and to overcome harmful gender norms and reduce intimate partner violence (IPV).

• Clinic-based intervention continues.
• Community-based intervention completed in September.
• CHARISMA pilot evaluation underway and effectiveness study planned.

Clinic-based intervention continues. CHARISMA is piloting its clinic-based intervention nested within the HIV Open Label Prevention Extension (HOPE) (MTN-025) dapivirine ring study at the Wits RHI Hillbrow site. As of October, the CHARISMA Social Benefits-Harms Tool (SBHT) has been administered to 94 women enrolled in HOPE to assess partner support and select counseling modules for each woman. CHARISMA empowerment counseling on partner communication, ring disclosure, and/or intimate partner violence (IPV) have been provided to each enrollee along with referrals to external partner organizations that provide a list of services beyond the scope of the site as needed. Also, 79 women have completed their Month 1 CHARISMA visit, 67 women have completed their Month 3 visit, and 31 women have completed their final scheduled CHARISMA visit at Month 6.

Community-based intervention completed in September. Sonke Gender Justice worked with community action teams to reach more than 13,000 community members in Hillbrow and Soweto from July 2016 to September 2017 through informal group dialogues, tavern dialogues, soccer tournaments, and door-to-door outreach. Sonke facilitators reported that community members were very interested in receiving information about new HIV prevention products and had many questions about the dapivirine ring. Facilitators also reported that men were increasingly interested in discussing IPV and started to shift their conceptualization of IPV as a domestic issue to one of national importance. Local NGOs addressing violence and other community structures, such as soccer clubs, have expressed interest in continuing some aspects of the community-based intervention to address IPV, gender-based violence (GBV) and HIV prevention in their communities.

CHARISMA pilot evaluation underway and effectiveness study planned. The team is conducting an evaluation of both the clinic- and community-based components of the CHARISMA pilot intervention. Based on the findings, the team will adapt the intervention to improve feasibility and scalability, seeking stakeholder input on possibilities. In partnership with USAID, and based on findings from the pilot intervention and stakeholder feedback, the team will design a randomized controlled study to assess the effectiveness of the CHARISMA intervention to increase PrEP uptake and adherence and to reduce social harms and IPV in the context of an oral PrEP demonstration project for young women.