November 25, 2019

New NIH study will test strategies to improve PrEP delivery to women receiving MCH services in Western Kenya

In February 2020, Global WACh researchers of ongoing PrEP implementation studies are launching a new five-year study titled, “PrEP in pregnancy, accelerating reach and efficiency (PrEPARE).”  PrEPARE is funded through a National Institute of Health supplement to the AGYW study, led by Global WACh Director, Dr. Grace John-Stewart and Dr. Pamela Kohler (Global Health, Psychosocial and Community Health) to evaluate PrEP adherence among adolescent girls and young women, and a K01 grant awarded to Dr. Anjuli Wagner (Acting Assistant Professor, Global Health).

Principal investigators, Drs. John-Stewart, Kohler, Wagner, and Dr. John Kinuthia (Kenyatta National Hospital, Nairobi, Kenya) will lead the PrEPARE study team that includes Global WACh researchers, Dr. Jillian Pintye (School of Nursing), Dr. Kristin Beima-Sofie (Global Health), Julia Dettinger (Global Health) and Laurén Gomez (Global Health).

Prior Global WACh-affiliated studies have demonstrated an increased risk of HIV acquisition during pregnancy and postpartum for women in high HIV burden regions, like Western Kenya.  By optimizing PrEP delivery to this population, the PrEPARE study aims to prevent HIV acquisition during this critical period in mothers’ and babies’ lives.  When taken daily as prescribed, PrEP is highly effective in preventing mothers from acquiring HIV and subsequently transmitting from mother to child.

 The PrEPARE study will rigorously test strategies to improve PrEP delivery to pregnant women seeking care at maternal child health (MCH) clinics in Western Kenya.  These strategies include video-based PrEP counseling, self-testing for repeat HIV testing, ways to dispense PrEP, and others identified by stakeholders (healthcare workers, PrEP users, and PrEP policymakers and implementers) during focus group discussions, surveys, and interviews.

Following the qualitative activities, the team will pilot each strategy through one of four Interrupted Time Series tests, a valuable research design for evaluating the effectiveness of population-level interventions at a clearly defined point in time, in 20 MCH facilities.  The team will synthesize what they learn into a report of best practices to optimize PrEP delivery within this setting.  The report will be a useful tool for stakeholders to translate implementation improvements into effective policies.  The team will also evaluate the budget impact of each of these strategies for PrEP delivery and assess the usefulness of these analyses in policymaker decision-making.