ePrEP Kenya Pilot

11/03/21-10/31/23
BMGF INV-037646; MPI: K Ortblad (Hutch), PI: M Sharma (UW); Kenyan PIs: K Ngure (JKUAT)
Project Director: D Were (Jhpiego); Project Coordinators: C Kiptinness (PHRD), R Mendonca (Audere), P Naik (UW), M Rafferty (MYDAWA)

Online pharmacy-delivered services have high potential to meet client preferences for convenience and privacy. Adding HIV pre-exposure prophylaxis (PrEP) to the diverse sexual and reproductive health (SRH) services and products already being offered online in Kenya could be an attractive alternative for clients who do not wish to access PrEP at pubilc health facilities. In addition to potentially benefitting clients (e.g., by reducing the amount of time they spend obtaining PrEP), delivering PrEP online through a public-private partnership may help increase efficiencies for public health systems by streamlining the supply chain, increasing reach through targeted marketing, and allowing for real-time monitoring of PrEP commodities and reporting of PrEP utilization metrics. For this pilot study, we are partnering with MYDAWA, an online pharmacy based in Nairobi that already offers many SRH services and products, including HIV self-tests, delivered directly to clients via courier service (often within 1-2 hours). The aim of this pilot is to develop a model of online PrEP delivery (Fig. 1) and pilot test it for 12 months, measuring both utilization (e.g., initiation, continuation) and implementation (e.g., acceptability, feasibility, costs) outcomes and identifying model weak points for refinement. This pilot, which is anticipated to start in September 2022, will be the first to test a model of online PrEP delivery in Africa.  

Publications

1. Kiptinness C^*, Naik P, Rafferty M, Thuo N, Malen R, Nyamasyo N, Stergachis A, Dettinger J, Isabelli P, Morris S, Wood T, Sharma M, Were D, Ngure K, Mugambi ML^†, Ortblad KF^†. Online HIV prophylaxis delivery: protocol for the ePrEP Kenya Pilot study. Front. Public Health. 2023; 11:1054559. [protocol]. PMCID: 1054559.
2. Chen Y^, Saldarriaga E, Montano MA, Ngure K, Thuo N, Kiptinness C, Rafferty M, Terris-Prestholt, Stergachis S, Mugambi ML, Ortblad KF, Sharma M. Assessing preferences for pre-exposure prophylaxis delivery services via online pharmacies in Kenya: protocol for a discrete choice experiment. BMJ Open. 2023; in press. [protocol].

Conference Presentations

1. Ekwunife O^, Culquichicon C, Rafferty M, Nyamasyo N, Were D, Ngure K, Mugambi M, Haakenstad A, Ortblad KF. Removal of an HIV self-test subsidy reduces online sales in Kenya. Poster presentation at CROI 2023: 30^th Conference on Retroviruses and Opportunistic Infections, Seattle, USA, February 19-22, 2023. #930.
2. Culquichicon C^, Ekwunife O, Rafferty M, Nyamasyo N, Were D, Ngure K, Mugambi M, Haakenstad A, Ortblad KF. Removal of an HIV self-test subsidy reduces online sales in Kenya. Presentation at SER 2023: Society for Epidemiologic Research 2023, Portland, USA, June 13-16, 2023. #156132.
3. Saldarriaga E^, Chen Y, Montano M, Ngure K, Thuo N, Kiptinness C, Terris-Prestholt F, Stergachis A, Ortblad KF, Mugambi ML, Sharma M. Client preferences for online pre-exposure prophylaxis service delivery in Kenya: a discrete choice experiment. ISPOR 2023: International Society for Pharmacoeconomics and Outcomes, Boston, USA, May 7-10, 2023.

^Ortblad mentee or team member

Abbreviations:
JKUAT: Jomo Kenyatta University
KEMRI: Kenya Medical Research Institute
PHRD: Partners in Health & Research Development
UW: University of Washington