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Stakeholder perspectives on interventions to improve HIV pre-exposure prophylaxis uptake and continuation in Lesotho: A participant-ranked preferences study.

作者信息

Chebet Joy J, McMahon Shannon A, Chase Rachel P, Tarumbiswa Tapiwa, Maponga Chivimbiso, Mandara Esther, Bärnighausen Till, Geldsetzer Pascal

机构信息

Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States of America.

Heidelberg Institute of Global Health, Heidelberg University, Germany.

出版信息

PLOS Glob Public Health. 2023 Sep 27;3(9):e0001423. doi: 10.1371/journal.pgph.0001423. eCollection 2023.


DOI:10.1371/journal.pgph.0001423
PMID:37756319
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10529554/
Abstract

Low uptake and high discontinuation remain major obstacles to realizing the potential of Pre-Exposure Prophylaxis (PrEP) in changing the trajectory of the HIV epidemic. We conducted a card sorting and ranking exercise with 155 local stakeholders to determine their views on the most important barriers and most promising interventions to achieving high PrEP coverage. Stakeholders were a purposive sample of PrEP policymakers and implementing partners (n = 7), healthcare providers (n = 51), and end-users (n = 97). End-users included adults who were currently using PrEP (n = 55), formerly using PrEP (n = 36), and those who were offered PrEP but declined (n = 6). Participants sorted pre-selected interventions and barriers to PrEP coverage into three piles-most, somewhat, and least important. Participants then ranked interventions and barriers in the "most important" piles in ascending order of significance. Ranked preferences were analyzed as voting data to identify the smallest set of candidates for which each candidate in the set would win in a two-candidate election against any candidate outside the set. Participants viewed a lack of PrEP awareness as the most important barrier to PrEP uptake for women, and a fear of HIV testing for men. Community-based HIV testing was ranked as the most promising intervention to improve PrEP uptake for both men and women. Perceived or experienced stigma was seen as an important barrier for PrEP continuation for both men and women, with an additional important barrier for men being daily activities that compete with the time needed to take a daily pill. Adherence counseling and multi-month PrEP prescriptions were seen as the most promising interventions to improve PrEP continuation. Our findings suggest community-based activities that generate PrEP demand (community-based HIV testing and mass media campaigns), reinforced with facility-based follow-up (counseling and multi-month prescription) could be promising interventions for PrEP programs that are aimed at the general adult population.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1af8/10529554/2d39067277ca/pgph.0001423.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1af8/10529554/86028868958c/pgph.0001423.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1af8/10529554/2d39067277ca/pgph.0001423.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1af8/10529554/86028868958c/pgph.0001423.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1af8/10529554/2d39067277ca/pgph.0001423.g002.jpg

相似文献

[1]
Stakeholder perspectives on interventions to improve HIV pre-exposure prophylaxis uptake and continuation in Lesotho: A participant-ranked preferences study.

PLOS Glob Public Health. 2023-9-27

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[2]
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[3]
Co-creating strategies to promote uptake of HIV self-testing among young adults in Mecklenburg county, North Carolina: a protocol for a pilot implementation study.

Front Health Serv. 2025-3-28

[4]
The effect of a social network-based intervention on adherence to HIV preexposure prophylaxis and HIV viral suppression among Kenyan fishermen.

AIDS. 2025-6-1

[5]
HIV Vulnerability Typologies Among Adolescent Girls and Young Women in Lesotho: A Population-Based, Cross-Sectional, Latent Class Analysis.

J Assoc Nurses AIDS Care. 2025-1-9

[6]
Enhanced Oral Pre-exposure Prophylaxis (PrEP) Implementation for Ugandan Fisherfolk: Pilot Intervention Outcomes.

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[7]
Demonstrating service delivery models for effective initiation and retention on pre-exposure prophylaxis (PrEP) among female bar workers in Dar es Salaam, Tanzania: A double randomized intervention study protocol.

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本文引用的文献

[1]
Knowledge and attitudes about HIV pre-exposure prophylaxis: Evidence from in-depth interviews and focus group discussions with policy makers, healthcare providers, and end-users in Lesotho.

PLOS Glob Public Health. 2022-10-3

[2]
Integration of pre-exposure prophylaxis services into public HIV care clinics in Kenya: a pragmatic stepped-wedge randomised trial.

Lancet Glob Health. 2021-12

[3]
Uptake, engagement, and adherence to pre-exposure prophylaxis offered after population HIV testing in rural Kenya and Uganda: 72-week interim analysis of observational data from the SEARCH study.

Lancet HIV. 2020-2-19

[4]
Global implementation of PrEP for HIV prevention: setting expectations for impact.

J Int AIDS Soc. 2019-8

[5]
Methods for exploring and eliciting patient preferences in the medical product lifecycle: a literature review.

Drug Discov Today. 2019-5-8

[6]
Young Women's Stated Preferences for Biomedical HIV Prevention: Results of a Discrete Choice Experiment in Kenya and South Africa.

J Acquir Immune Defic Syndr. 2019-4-1

[7]
A systematic review of adherence to oral pre-exposure prophylaxis for HIV - how can we improve uptake and adherence?

BMC Infect Dis. 2018-11-16

[8]
Divergent Preferences for HIV Prevention: A Discrete Choice Experiment for Multipurpose HIV Prevention Products in South Africa.

Med Decis Making. 2017-9-1

[9]
A Global Estimate of the Acceptability of Pre-exposure Prophylaxis for HIV Among Men Who have Sex with Men: A Systematic Review and Meta-analysis.

AIDS Behav. 2018-4

[10]
Values and Preferences on the Use of Oral Pre-exposure Prophylaxis (PrEP) for HIV Prevention Among Multiple Populations: A Systematic Review of the Literature.

AIDS Behav. 2017-5

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