دورية أكاديمية
أعرض في EDS

Provider perspectives on service delivery modifications to maintain access to HIV pre-exposure prophylaxis during the COVID-19 pandemic: qualitative results from a PrEP implementation project in Kenya.

التفاصيل البيبلوغرافية
العنوان: Provider perspectives on service delivery modifications to maintain access to HIV pre-exposure prophylaxis during the COVID-19 pandemic: qualitative results from a PrEP implementation project in Kenya.
المؤلفون: Velloza J; Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California, USA., Roche SD; Public Health Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA., Owidi EJ; Partners in Health and Research Development, Thika, Kenya., Irungu EM; Jhpiego, Nairobi, Kenya., Dollah A; Washington State University - Global Health Kenya, Nairobi, Kenya., Kwach B; Kenya Medical Research Institute, Kisumu, Kenya., Thuo NB; Partners in Health and Research Development, Thika, Kenya., Morton JF; Department of Global Health, University of Washington, Seattle, Washington, USA., Mugo N; Partners in Health and Research Development, Thika, Kenya.; Department of Global Health, University of Washington, Seattle, Washington, USA., Bukusi EA; Kenya Medical Research Institute, Kisumu, Kenya.; Department of Global Health, University of Washington, Seattle, Washington, USA., O'Malley G; Department of Global Health, University of Washington, Seattle, Washington, USA., Ngure K; Department of Global Health, University of Washington, Seattle, Washington, USA.; Department of Community Health, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya., Baeten JM; Department of Global Health, University of Washington, Seattle, Washington, USA.; Gilead Sciences, Foster City, California, USA.; Department of Medicine, University of Washington, Seattle, Washington, USA.; Department of Epidemiology, University of Washington, Seattle, Washington, USA., Mugwanya KK; Department of Global Health, University of Washington, Seattle, Washington, USA.; Department of Epidemiology, University of Washington, Seattle, Washington, USA.
مؤلفون مشاركون: Partners Scale-Up Project Team
المصدر: Journal of the International AIDS Society [J Int AIDS Soc] 2023 Feb; Vol. 26 (2), pp. e26055.
نوع المنشور: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: John Wiley & Sons, Inc Country of Publication: Switzerland NLM ID: 101478566 Publication Model: Print Cited Medium: Internet ISSN: 1758-2652 (Electronic) Linking ISSN: 17582652 NLM ISO Abbreviation: J Int AIDS Soc Subsets: MEDLINE
أسماء مطبوعة: Publication: 2017- : Hoboken, NJ : John Wiley & Sons, Inc
Original Publication: [London] : BioMed Central
مواضيع طبية MeSH: HIV Infections*/epidemiology , HIV Infections*/prevention & control , HIV Infections*/drug therapy , Pre-Exposure Prophylaxis*/methods , COVID-19*/prevention & control , Anti-HIV Agents*/therapeutic use, Humans ; Female ; Adult ; Male ; Pandemics/prevention & control ; Kenya/epidemiology
مستخلص: Introduction: HIV pre-exposure prophylaxis (PrEP) is an essential prevention strategy being scaled up for priority populations in Kenya, including for HIV serodiscordant couples. The COVID-19 pandemic posed challenges to PrEP rollout. We conducted a qualitative study of PrEP providers to understand how clinics adjusted PrEP delivery during the COVID-19 pandemic.
Methods: Since 2017, the Partners Scale-Up Project has integrated PrEP into 25 HIV clinics in Central and Western Kenya. We conducted qualitative interviews with 40 purposively sampled clinic personnel. We interviewed personnel once during the first pandemic wave (May-Aug 2020) and again after some decline in COVID-19 rates (Nov-Jan 2021). We analysed data using inductive memo-writing and summarized data by themes along the PrEP delivery cascade, guided by the Framework for Reporting Adaptation and Modifications (FRAME).
Results: We interviewed 27 clinical officers, five nurses, four health records and information officers, and four counsellors from Central (n = 20) and Western (n = 20) Kenya. About half (n = 19) were female, with a median age of 32 (IQR: 29-34) and 2.3 years of experience delivering PrEP (IQR: 2-3). All participants reported clinic changes in PrEP demand creation and service delivery during the pandemic. Modifications occurred during PrEP implementation and sustainment phases, were partly reactive to the pandemic and also facilitated by interim Ministry of Health guidance on PrEP delivery during COVID, and were made by PrEP delivery teams, clients and clinic managers. Commonly reported modifications included dispensing multiple-month PrEP refills, intensifying phone-based client engagement and collaborating with other HIV clinics to ensure that clients with prolonged stays in other regions could continue to access PrEP. Some clinics also adopted practices to streamline visits, such as within clinical-room PrEP dispensing, pre-packing PrEP and task-shifting. Most providers liked these changes and hoped they would continue after the pandemic subsides.
Conclusions: COVID-19 served as a catalyst for PrEP delivery innovations in Kenya. HIV clinics successfully and rapidly adapted their PrEP demand creation, refill and retention strategies to promote PrEP uptake and effective use. These modified implementation strategies highlight opportunities to streamline the delivery of PrEP, as well as other HIV and chronic care services, and strengthen engagement with populations post-pandemic.
(© 2023 The Authors. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of the International AIDS Society.)
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معلومات مُعتمدة: OPP10556051 United States GATES Bill & Melinda Gates Foundation; K99MH123369 United States MH NIMH NIH HHS; R00MH118134 United States MH NIMH NIH HHS; R01MH095507 United States MH NIMH NIH HHS
فهرسة مساهمة: Keywords: COVID-19; HIV; Kenya; adaptation; pre-exposure prophylaxis; serodiscordant couples
المشرفين على المادة: 0 (Anti-HIV Agents)
تواريخ الأحداث: Date Created: 20230205 Date Completed: 20230207 Latest Revision: 20230227
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC9899492
DOI: 10.1002/jia2.26055
PMID: 36739603
قاعدة البيانات: MEDLINE
الوصف
تدمد:1758-2652
DOI:10.1002/jia2.26055