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PrEP and choice counselling - Insights into implementation.

Melanie Pleaner1, Faith Musvipwa1, Siphokazi Dada1

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Summary
This summary is machine-generated.

Choice counselling for HIV prevention methods like oral pre-exposure prophylaxis (PrEP) and the dapivirine vaginal ring (DVR) is crucial. Ongoing support and addressing provider bias are key for effective implementation and informed client choices.

Keywords:
HIV preventionPrEP choicechoice counsellingpre-exposure prophylaxistrainingtransfer of learning

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Area of Science:

  • Public Health
  • HIV Prevention
  • Implementation Science

Background:

  • Adolescent girls and young women face a disproportionate burden of HIV.
  • Oral pre-exposure prophylaxis (PrEP) significantly advanced HIV prevention.
  • The dapivirine vaginal ring (DVR) introduction in South Africa expanded HIV prevention choices.

Purpose of the Study:

  • To describe an iterative, participative process for understanding choice counselling training and implementation for new HIV prevention methods.
  • To assess the site-level implementation of choice counselling for the dapivirine vaginal ring (DVR) and oral pre-exposure prophylaxis (PrEP).
  • To identify gaps and inform future training and mentoring for effective choice counselling.

Main Methods:

  • Conducted 42 interviews with clinical and non-clinical healthcare providers involved in DVR delivery.
  • Utilized the Transfer of Learning Matrix to guide the assessment process.
  • Employed thematic analysis on audio-recorded and transcribed interviews.

Main Results:

  • Healthcare providers must communicate neutrally, avoiding personal bias.
  • One-time trainings and job aids are insufficient for effective choice counselling.
  • Active engagement with providers on the ground is necessary for ongoing training and mentoring.

Conclusions:

  • Effective choice counselling requires continuous support and adaptation.
  • Addressing provider bias is essential for equitable HIV prevention service delivery.
  • Ongoing in-service training and mentoring are vital to address implementation gaps.