POWER – February 2017

POWER develops cost-effective and scalable models for implementation of ARV-based HIV prevention products for women.

• POWER formative report finalized.
• Community survey about oral PrEP underway.
• POWER open label oral PrEP cohort launch scheduled.
• Pre-testing of oral PrEP decision support tool initiated.

POWER formative report finalized. The POWER team submitted the final report of the results from the formative work to USAID in January and will be available on PrEPWatch in March. The formative work consisted of mental models and key informant interviews with young women, men, and health care providers and other key stakeholders. The mental models methodology, led by Carnegie Mellon, is grounded in behavioral decision research. In-depth interviews (IDIs) with young women and men assessed how people interpret risk information, in this case HIV and pregnancy risks, and how they make subsequent choices, informed by their own intricate web of beliefs and theories – i.e., mental models. This analysis characterizes these mental models with respect to a specific decision, such as factors that would influence their decision to use oral PrEP. The key informant interviews, led by RTI International, focused on oral PrEP delivery for young African women and probed provider and opinion leaders about where, how, and to whom to deliver oral PrEP.

Community survey about oral PrEP underway. As part of the mental models formative work, the team is using a community-based survey to quantify some of the key themes identified in the in-depth interviews with young women and men. The survey was pre-tested in Cape Town and Kisumu in December and has already been completed in Cape Town (N=144). It was launched in late January in Johannesburg and Kisumu. POWER will use rapid analysis, and the results will augment the qualitative interviews as part of the mental models analysis.

POWER open label oral PrEP cohort launch scheduled. All three sites (Johannesburg, Cape Town, and Kisumu) are in the final stages of receiving IRB/ethics approvals, securing import permits for oral PrEP donation, and finalizing clinic flow and other clinical/lab/pharmacy processes. All three sites will complete site activation training and study launch in spring 2017. The POWER cohorts, where oral PrEP will be delivered to young women ages 16-25, will take place at a mobile youth clinic in Cape Town, a youth clinic in Johannesburg, and a family-planning clinic in Kisumu.

Pre-testing of oral PrEP decision support tool initiated. The POWER team is developing an oral PrEP decision support tool, My PrEP, with the digital version modeled from My Birth Control, created by Bedsider.org and UCSF. Pre-testing of the prototype at three sites initiated in December. The objective is to provide an interactive decision tool that offers graphic displays of the rationale for oral PrEP, HIV risks, efficacy, side effects, and adherence, to facilitate young women considering oral PrEP before they meet with a provider. Ultimately, My PrEP will be integrated with My Birth Control, since some young women may also be seeking contraceptive services.