Peer PrEP Pilot & Trial

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. 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.