The MPii projects had two concepts accepted for AIDS 2016, which will be held in Durban, South Africa in July. Come check us out at these events:
OPTIONS, USAID, and WHO will co-host a Global Village youth workshop titled, “The HIV prevention landscape for women: A look at new and emerging HIV prevention options, including PrEP, vaginal rings and new products in development.” It will include three expert presentations and a panel discussion that will provide a forum to discuss women’s needs and expectations for new HIV prevention technologies.
A Scientific Skills Development workshop, titled, “What do we need to access and deliver PrEP?: tapping into the unheard voices of end-users and providers to support country-level advocacy and ensure equitable access to PrEP” will also be co-hosted by OPTIONS, USAID, and WHO. Panel discussions with end users, service providers, and national policy makers will identify key considerations for using PrEP, explore experiences in providing it, and develop advocacy strategies for national-level needs.
The OPTIONS Consortium objective is to develop a streamlined, adaptable product delivery platform for current and future ARV-based HIV prevention options, with a particular focus on women.
Value Chain Situation Analyses for PrEP completed. The OPTIONS team completed the value chain situation analyses, and those for Kenya and Zimbabwe are available on PrEPWatch. If you have questions or are interested in conducting a value chain analysis of your own, please contact Neeraja Bhavaraju.
Modeling priorities identified. The OPTIONS’ PrEP modeling literature review is available on PrEPWatch. The OPTIONS modeling team identified Kenya and Zimbabwe as priority countries to dive deeper into modeling activities. Initial work will explore whether there are specific subpopulations for which providing PrEP in addition to the existing suite of prevention interventions and ART scale-up may (a) provide a large additional epidemiological impact, and (b) be cost-effective. More detailed modeling questions will be asked based on findings from this initial work.
South Africa National Technical Working Group (TWG) engaged. OPTIONS/Wits RHI continues to have an active coordination role within the South Africa PrEP and Test and Treat (T&T) TWG and is now convening the Adolescent Girls and Young Women (AGYW) subcommittee. The Deputy President launched the National Sex Worker HIV Plan in March, with a goal of rolling out PrEP nationally to sex workers beginning in June 2016. Wits RHI is working closely with South Africa’s National Department of Health (SA NDOH) and McCann Global Health to create communications materials for the launch, as well as with the South African HIV Clinicians Society on the training materials for clinicians, counselors, and peer educators.
Clearinghouse launched. OPTIONS/AVAC developed a new section of PrEPWatch, a clearinghouse of information on PrEP science, research, cost, access and advocacy, focused on implementation efforts underway. Specifically, the USAID-Supported Initiatives page offers an overview of the five MPii projects, and country close-up pages for Kenya, South Africa, and Zimbabwe give the full spectrum of product introduction work for oral PrEP, dapivirine ring, and OPTIONS activities as applicable. PrEPWatch will continue to grow as PrEP introduction and rollout moves forward and as new efforts and initiatives are started by all MPii projects. Please send suggested documents for posting to MPiiPrEPWatch@optionsconsortium.org.
POWER develops cost-effective and scalable models for implementation of ARV-based HIV prevention products for women.
On-site training conducted. All three POWER sites (Kisumu, Kenya; Johannesburg and Cape Town, South Africa) participated in on-site training for data collection regarding the mental model in-depth interviews (an approach that examines how a person’s beliefs influence decision making) and key informant interviews. In total, 23 members of the research team were trained. Two sites started data collection at the end of April.
PrEP delivery protocol drafted. The POWER team, including USAID representatives, met in February to finalize the PrEP delivery cohort design and implementation plan. Based on the consensus reached at that meeting, the PrEP delivery protocol has been drafted and will be finalized in early May. Regulatory submissions will be initiated at all sites in May or June 2016.
EMOTION increases uptake and correct and consistent use of ARV-based HIV prevention products by women at high risk of HIV infection using an end-user centered strategy.
First HCD trip completed and umbrella brand developed. EMOTION completed its first human centered design (HCD) trip, Kalahari 1, in December 2015. The team interviewed more than 50 young women, men, health care providers and community leaders in both urban and rural regions in South Africa. Eight PrEP products – oral tablet, vaginal ring, injectable, patch, vaginal insert, vaginal film, intrauterine device, and implant – were shown and discussed. Based on the feedback received, the team summarized the design principles and developed a unique umbrella brand and outlined message themes. Additionally, the design of two PrEP products was improved for further iteration.
Second HCD trip planned. EMOTION chose two products to include for the second phase of the HCD study, Kalahari 2, which is scheduled to kick off in May. The team will visit South Africa in June 2016. Feedback will be collected from live prototyping experiments. These results will guide the final design iterations, while also inform the socio-behavioral study and product introduction campaign.
Pilot marketing study designed. Abt Associates has partnered with Matchboxology, a marketing and advertising firm in South Africa, to conduct a pilot marketing study using controlled market behavior simulation methodology, in the eThekwini Municipality of Durban, as well as Johannesburg and Cape Town later this year.
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).
HOPE intervention design underway. The CHARISMA intervention is intended to be added on to HOPE, the open label extension study of ASPIRE. A secondary data review and formative data collection will inform the development of a model intervention to: 1) measure what kind of male partner support or harm HOPE participants are experiencing; 2) support participants’ agency to safely and consistently use the dapivirine vaginal ring; and 3) constructively engage men in women’s microbicide use, as appropriate.
Social harms and IPV data analysis continued. The team continues to review the extent and types of social harms and intimate partner violence (IPV) reported in recent MTN and CAPRISA microbicide trials. Researchers will then evaluate how these events are measured in study communities to inform the development and finalization of the Social Benefits-Harms Tool (SBHT) and the counseling component of the intervention. Once finalized, the tool will be used to assess where women are on the continuum of partner involvement and support of microbicide use, enabling intervention activities, including the counseling topics and approach, to be tailored to women’s individual circumstances. Additionally, researchers conducted secondary analyses of male engagement data from interviews with CAPRISA 008 participants and staff.
Scaled social benefits-harms tool conceptualized. To identify, measure, and address the ways in which gender norms and power differentials affect women’s agency, the team drafted a conceptual framework for the SBHT based on a literature review of 5,772 articles.
Qualitative research study underway. Wits RHI, RTI and FHI 360 received ethical approvals for a formative research study with ASPIRE trial participants and their partners. The team trained interviewers in Johannesburg on qualitative methodology, the study protocol, and the study interview guides, then researchers conducted pilot interviews with colleagues. The study team will now complete formative in-depth interviews and will use the subsequent data analysis to inform the HOPE CHARISMA intervention.
GEMS informs policies and defines programmatic considerations related to use of ARV-based HIV prevention products and risk of resistance.
Information from PrEP trials and demo projects gathered. The GEMS team is working with OPTIONS and other partners to compile information about the current status of resistance evaluation in seroconverters from ongoing and completed PrEP trials and demonstration projects.
Model assumptions analysis ongoing. The team is reviewing model assumptions relating to drug resistance and PrEP and will update the model based on new available data.
Policy and implementation steering committee convened. The GEMS steering committee met to discuss in-country activities related to PrEP roll out and resistance testing. The steering committee includes MPii colleagues and PrEP implementers from South Africa, Zimbabwe and Kenya.
Country-specific PrEP guidance reviewed. The team is researching country guidance documents related to PrEP use and HIV testing and working with WHO to review current recommendations for HIV testing frequency while using PrEP. The GEMS team also participated in the WHO’s PrEP Implementation Tool event during CROI 2016.
Determination of sample collection methods underway. The lab team is working with industry partners to acquire the latest technologies for blood sample collection and shipping. They have started experiments to evaluate which method will be logistically feasible for collection and optimal for resistance testing.
OPTIONS
“Six Advocates for PrEP Speak Out.” UNAIDS Community Advocacy Update. 18 Feb 2016.
“Opinion: A Possible Game-Changer in HIV Prevention.” Eyewitness News. Mar 2016.
“Why Africa needs PrEP: A two-in-one pill to prevent HIV infection.” Mail & Guardian Bhekisisa Centre for Health Journalism. 10 Mar 2016.