Improving risk perception and uptake of pre-exposure prophylaxis (PrEP) through interactive feedback-based counselling with and without community engagement in young women in Manicaland, East Zimbabwe: study protocol for a pilot randomized trial.

Journal: Trials

Volume: 20

Issue: 1

Year of Publication: 2020

Affiliated Institutions:  Department of Health Policy, London School of Economics and Political Science, Cowdray House, London, WC AE, UK. r.a.thomas@lse.ac.uk. Section of Health Services Research, Department of Public Health, University of Copenhagen, Øster Farimagsgade opg. B, Postb, , Building: .., , København K, Denmark. Department of Psychological and Behavioural Science, London School of Economics and Political Science, London, WC AE, UK. Department of Infectious Disease Epidemiology, Imperial College London, St Mary's Campus Norfolk Place, London, W PG, UK. Biomedical Research and Training Institute, Seagrave, Avondale, Harare, Zimbabwe.

Abstract summary 

HIV incidence in adolescent girls and young women remains high in sub-Saharan Africa. Progress towards uptake of HIV prevention methods remains low. Studies of oral pre-exposure prophylaxis (PrEP) have shown that uptake and adherence may be low due to low-risk perception and ambivalence around using antiretrovirals for prevention. No evidence exists on whether an interactive intervention aimed at adjusting risk perception and addressing the uncertainty around PrEP will improve uptake. This pilot research trial aims to provide an initial evaluation of the impact of an interactive digital tablet-based counselling session, correcting risk perception, and addressing ambiguity around availability, usability, and effectiveness of PrEP.This is a matched-cluster randomized controlled trial which will compare an interactive tablet-based education intervention against a control with no intervention. The study will be implemented in eight sites. In each site, two matched clusters of villages will be created. One cluster will be randomly allocated to intervention. In two sites, a community engagement intervention will also be implemented to address social obstacles and to increase support from peers, families, and social structures. A total of 1200 HIV-negative young women aged 18-24 years, not on PrEP at baseline, will be eligible. Baseline measures of endpoints will be gathered in surveys. Follow-up assessment at six months will include biomarkers of PrEP uptake and surveys.This will be the first randomized controlled trial to determine whether interactive feedback counselling leads to uptake of HIV prevention methods such as PrEP and reduces risky sexual behavior. If successful, policymakers could consider such an intervention in school-based education campaigns or as post-HIV-testing counselling for young people.Clinicaltrials.gov, NCT03565575. Registered on 21 June 2018.

Authors & Co-authors:  Thomas Ranjeeta R Skovdal Morten M Galizzi Matteo M MM Schaefer Robin R Moorhouse Louisa L Nyamukapa Constance C Maswera Rufurwokuda R Mandizvidza Phyllis P Hallett Timothy B TB Gregson Simon S

Study Outcome 

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Statistics
Citations :  UNAIDS . Women and HIV: A spotlight on adolescent girls and young women. Geneva: UNAIDS; 2019.
Authors :  10
Identifiers
Doi : 668
SSN : 1745-6215
Study Population
Women,Girls
Mesh Terms
Adolescent
Other Terms
HIV prevention;Pre-exposure prophylaxis;Randomized trial;Zimbabwe
Study Design
Randomized Control Trial
Study Approach
Country of Study
Zimbabwe
Publication Country
England