Peer HIV PrEP Referral
Figure 1. Core components of the peer PrEP referral + HIV self-testing intervention
Peer PrEP Pilot & Trial [completed]
04/01/20-08/31/24
NIH R00 MH121166, PI: K Ortblad (Hutch); Kenyan PI: K Ngure (JKUAT)
Project Coordinators: M McGowan (Heidelberg), P Mogere (PHRD), N Wairimu [PHRD), A Reedy (Hutch)
Use of pre-exposure prophylaxis (PrEP) for HIV prevention has been suboptimal among young women at risk of HIV infection in Kenya. Through formative research with PrEP-experienced and PrEP-naïve young women, we designed a model of peer PrEP referral + HIV self-testing (HIVST), Fig. 1, that participants anticipated would be acceptable to young women and feasible to implement in Kenya. In this model, female PrEP users (age 16 to 24 years old) are trained to talk to their peers about PrEP, provide them with HIVSTs, refer them to facility-based PrEP services, and support their continued PrEP use (e.g., by checking in on them and encouraging PrEP use during periods of HIV risk). In February 2022 we began a 6-month pilot test of this model, which we will refine and further test in a hybrid effectiveness-implementation trial beginning in fall of 2022, Fig 2. We hypothesize that, compared to informal word-of-month referrals among peers, formalized peer PrEP referral enhanced with HIVST will increase PrEP initiation, continuation, and adherence, be low cost to implement, and have high acceptability and fidelity.
Figure 2. Design of the Peer PrEP two-arm cluster-randomized trial
Publications
- McGowan M, Wairimu N, Reedy AM, Mogere P, Culquichicon C, Njeru I, Malen RC, Jahn A, Bärnighausen T, Roche SD, Ngure K, Ortblad KF. Formalized peer referral to HIV pre-exposure prophylaxis supported with self-testing: a mixed-methods pilot study among young Kenyan women. Front Public Health. 2024;12:1428609. [original research].
- Wairimu N, Malen RC, Reedy AM, Mogere P, Njeru I, Culquichicon C, McGowan M, Gao F, Baeten JM, Ngure K, Ortblad KF. Peer PrEP referral + HIV self-test delivery for PrEP initiation among young Kenyan women: study protocol for a cluster-randomized controlled trial. Trials. 2023;24(1):705. [protocol]. PMCID: 10625301.
- McGowan M^, Casmir E, Wairimu N, Jahn A, Mogere P, Ngure K, Ortblad KF, Roche S. Assessing young Kenyan women’s willingness to engage in a peer-delivered HIV self-testing and referral model for PrEP initiation: a qualitative formative research study. Front Public Health. 2022; 10:932948. [original work]. PMCID: 9583529.
Select conference presentations
- McGowan M^, Wairimu N, Mogere P, Njeru I, Ongachi S, Reedy AM, Malen R, Culquichicon C, Baeten JM, Ngure K, Ortblad KF. Peer PrEP referral + HIV self-testing delivery for PrEP initiation among adolescent girls and young women in Kenya: a mixed-methods pilot study. Poster presentation at IAS 2023: 12th IAS Conference on HIV Science, Brisbane, Australia, July 23-26, 2023. Abstract EPE0797.
- Wairimu N^*, McGowan M, Njeru I, Reedy AM, Mogere P, Malen RC, Culquichicon C, Baeten JM, Ngure K, Ortblad KF. Perceptions of long-acting injectable HIV pre-exposure prophylaxis among adolescent girls and young women in Kenya. Poster presentation at INTEREST 2023: International Conference on HIV treatment, pathogenesis, and prevention research in resource-limited settings, Maputo, Mozambique, May 9-12, 2023. Abstract 508.
- McGowan M^, Casmir E, Wairimu N, Mogere P, Ngure K, Ortblad KF. The acceptability of a peer PrEP referral + HIV self-test delivery model to facilitate PrEP initiation among adolescent girls and young women in Kenya. Oral presentation at Adherence 2021: 16th International Conference on HIV Treatment and Prevention Adherence, Orlando, USA, November 7-9, 2021. Abstract 1164.
Abbreviations:
JKUAT: Jomo Kenyatta University
KEMRI: Kenya Medical Research Institute
PHRD: Partners in Health & Research Development
UW: University of Washington
^Ortblad mentee or team member
^* With mentored Kenyan research team member as lead author
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