9
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Prospective acceptability of a multipurpose technology (MPT) implant in preclinical development to prevent HIV and unplanned pregnancy: Qualitative insights from women end users and health care providers in South Africa and Zimbabwe

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Given the high rates of both HIV and unintended pregnancies in sub-Saharan Africa, the SCHIELD program aims to develop a multipurpose technology implant for HIV and pregnancy prevention. An end-user evaluation was undertaken with young women and health care providers to assess preferences for modifiable implant attributes to improve future adoption and rollout.

          Methods

          Focus group discussions were conducted with potential women end users, and health care providers experienced in implant insertion or removal participated in in-depth interviews. All participants were recruited from Harare, Zimbabwe, or Soshanguve, South Africa. The purposively stratified sampled women were either implant experienced or implant naïve and were categorized into three groups: nulliparous, postpartum, or engaged in transactional sex. Topics covered included duration (six months to three years), biodegradability, removability, and independent rod retrievability (per indication). Data were analyzed using Dedoose software and summarized into emerging themes.

          Results

          Participants identified three key areas that could facilitate rollout, uptake, and adherence of an implant for HIV and pregnancy prevention. First, discreetness was the most salient topic and was associated with implant characteristics such as anatomical location, flexibility, and biodegradability. Second, the ability to independently retrieve the HIV or pregnancy prevention component was preferred, as life circumstances may change and was favored by all participants, except for young women in Soshanguve. Third, there is a need for proper counseling, sensitization, provider training, and health campaigns to facilitate rollout of a 2-in-1 implant.

          Conclusions

          A 2-in-1 implant was seen as highly desirable by most young women and health care providers. Participants discussed potential concerns and barriers to uptake of a biodegradable implant with dual HIV prevention and contraceptive properties, identifying key implant attributes that product developers can modify while still in preclinical stages.

          Related collections

          Most cited references44

          • Record: found
          • Abstract: found
          • Article: found
          Is Open Access

          The influence of HIV‐related stigma on PrEP disclosure and adherence among adolescent girls and young women in HPTN 082: a qualitative study

          Abstract Introduction Stigma and disclosure concerns have been key barriers to oral pre‐exposure prophylaxis (PrEP) adherence for African adolescent girls and young women (AGYW) in efficacy trials. We aimed to understand the impact of these factors among African AGYW in an open‐label PrEP study. Methods HPTN 082 was an open‐label PrEP study among AGYW (ages 16 to 24) in Harare, Zimbabwe, and Cape Town and Johannesburg, South Africa from 2016 to 2018. Women starting PrEP were randomized to standard adherence support (counselling, two‐way SMS, monthly adherence clubs) or standard support plus drug‐level feedback. Serial in‐depth interviews were conducted among 67 AGYW after 13‐week and 26‐week study visits to explore experiences of stigma, disclosure and PrEP adherence. We analysed data by coding transcripts and memo‐writing and diagramming to summarize themes. Results AGYW described stigma related to sexual activity (e.g. “people say I'm a prostitute”) and being perceived to be living with HIV because of taking antiretrovirals (e.g. “my husband's friends say I'm HIV infected”). Participants who anticipated stigma were reluctant to disclose PrEP use and reported adherence challenges. Disclosure also resulted in stigmatizing experiences. Across all sites, negative descriptions of stigma and disclosure challenges were more common in the first interview. In the second interview, participants often described disclosure as an “empowering” way to combat community‐level PrEP stigma; many said that they proactively discussed PrEP in their communities (e.g. became a “community PrEP ambassador”), which improved their ability to take PrEP and encourage others to use PrEP. These empowering disclosure experiences were facilitated by ongoing HPTN 082 study activities (e.g. counselling sessions, adherence clubs) in which they could discuss PrEP‐related stigma, disclosure and PrEP adherence issues. Conclusions Stigma and disclosure challenges were initial concerns for African AGYW newly initiating PrEP but many were empowered to disclose PrEP use over their first six months of PrEP use, which helped them cope with stigma and feel more able to take PrEP regularly. PrEP programmes can foster disclosure through community and clinic‐based discussion, adherence clubs and activities normalizing sexual behaviour and PrEP use, which can reduce stigma and improve PrEP adherence and thus effectiveness.
            Bookmark
            • Record: found
            • Abstract: not found
            • Article: not found

            PrEP rollout in Africa: status and opportunity

              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Acceptability and use of a dapivirine vaginal ring in a phase III trial.

              The MTN-020/ASPIRE trial evaluated the safety and effectiveness of the dapivirine vaginal ring for prevention of HIV-1 infection among African women. A nested qualitative component was conducted at six of 15 study sites in Uganda, Malawi, Zimbabwe and South Africa to evaluate acceptability of and adherence to the ring.
                Bookmark

                Author and article information

                Contributors
                Role: Data curationRole: Formal analysisRole: InvestigationRole: Writing – original draft
                Role: Data curationRole: Formal analysisRole: InvestigationRole: Project administrationRole: Writing – original draft
                Role: Formal analysisRole: MethodologyRole: Project administrationRole: Writing – original draft
                Role: Data curationRole: Formal analysisRole: VisualizationRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: InvestigationRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: InvestigationRole: Writing – review & editing
                Role: Project administrationRole: SupervisionRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: SupervisionRole: Writing – review & editing
                Role: Project administrationRole: SupervisionRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: SupervisionRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                PLOS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                17 May 2023
                2023
                : 18
                : 5
                : e0285711
                Affiliations
                [1 ] Pangaea Zimbabwe AIDS Trust, Harare, Zimbabwe
                [2 ] Women’s Global Health Imperative, RTI International, San Jose, California, United States of America
                [3 ] Setshaba Research Centre, Soshanguve, South Africa
                [4 ] Faculty of Health Sciences, Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa
                [5 ] RTI International, Research Triangle Park, North Carolina, United States of America
                [6 ] ASTRA Consulting, Kensington, California, United States of America
                [7 ] Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, California, United States of America
                Boston College School of Social Work, UNITED STATES
                Author notes

                Competing Interests: The technology disclosed in this manuscript is protected by pending US Patent application US 20210346661 A1 (and corresponding international applications) and PCT application WO/2021/207329 (and corresponding international applications) with LMJ and AVS as named inventors.

                Author information
                https://orcid.org/0000-0003-2272-482X
                https://orcid.org/0000-0001-9805-3132
                https://orcid.org/0000-0003-1509-5092
                https://orcid.org/0000-0003-0309-1641
                Article
                PONE-D-21-39769
                10.1371/journal.pone.0285711
                10191314
                37195918
                1b33af7b-5c76-489a-a148-0e4578f76993
                © 2023 Nkomo et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 17 December 2021
                : 1 May 2023
                Page count
                Figures: 1, Tables: 7, Pages: 21
                Funding
                Funded by: USAID
                Award ID: AID-OAA-A-17-00011
                Award Recipient :
                This research was made possible by the generous support of the American people through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR): USAID Cooperative Agreement number AID-OAA-A-17-00011. The contents are the responsibility of the authors and do not necessarily reflect the views of USAID, PEPFAR, or the United States Government. Funding was received by LMJ. USAID ( https://www.usaid.gov/) reviewed and approved the study design and a draft of this manuscript.
                Categories
                Research Article
                Biology and Life Sciences
                Bioengineering
                Biotechnology
                Medical Devices and Equipment
                Medical Implants
                Engineering and Technology
                Bioengineering
                Biotechnology
                Medical Devices and Equipment
                Medical Implants
                Medicine and Health Sciences
                Medical Devices and Equipment
                Medical Implants
                Medicine and health sciences
                Public and occupational health
                Preventive medicine
                HIV prevention
                Medicine and Health Sciences
                Health Care
                Health Care Providers
                Medicine and Health Sciences
                Women's Health
                Obstetrics and Gynecology
                Contraception
                Female Contraception
                Medicine and Health Sciences
                Women's Health
                Maternal Health
                Pregnancy
                Medicine and Health Sciences
                Women's Health
                Obstetrics and Gynecology
                Pregnancy
                Biology and Life Sciences
                Microbiology
                Medical Microbiology
                Microbial Pathogens
                Viral Pathogens
                Immunodeficiency Viruses
                HIV
                Medicine and Health Sciences
                Pathology and Laboratory Medicine
                Pathogens
                Microbial Pathogens
                Viral Pathogens
                Immunodeficiency Viruses
                HIV
                Biology and Life Sciences
                Organisms
                Viruses
                Viral Pathogens
                Immunodeficiency Viruses
                HIV
                Biology and Life Sciences
                Organisms
                Viruses
                Immunodeficiency Viruses
                HIV
                Biology and life sciences
                Organisms
                Viruses
                RNA viruses
                Retroviruses
                Lentivirus
                HIV
                Biology and Life Sciences
                Microbiology
                Medical Microbiology
                Microbial Pathogens
                Viral Pathogens
                Retroviruses
                Lentivirus
                HIV
                Medicine and Health Sciences
                Pathology and Laboratory Medicine
                Pathogens
                Microbial Pathogens
                Viral Pathogens
                Retroviruses
                Lentivirus
                HIV
                Biology and Life Sciences
                Organisms
                Viruses
                Viral Pathogens
                Retroviruses
                Lentivirus
                HIV
                People and Places
                Population Groupings
                Professions
                Medical Personnel
                Nurses
                Medicine and Health Sciences
                Health Care
                Health Care Providers
                Nurses
                Medicine and Health Sciences
                Pharmacology
                Drugs
                Contraceptives
                Biology and Life Sciences
                Bioengineering
                Biotechnology
                Medical Devices and Equipment
                Contraceptives
                Engineering and Technology
                Bioengineering
                Biotechnology
                Medical Devices and Equipment
                Contraceptives
                Medicine and Health Sciences
                Medical Devices and Equipment
                Contraceptives
                Custom metadata
                We have created a minimal data set for quantitative data presented in this paper and provided it in the Supporting information files. We have replaced participant ages with age ranges to fully ensure deidentification of the data. Full transcripts will not be made publicly available due to the sensitive nature of the information contained therein, and the inability to ensure that a full transcript is completely de-identified. While direct identifiers and location names were not included in transcripts when they were prepared, there are no standardized procedures and tools for de-identifying sensitive qualitative data and removing indirect identifiers. In addition, qualitative research participants were assured during the informed consent process that their identity would remain confidential. Upon request, approval to access these data may be provided through a Data Use Agreement by RTI International. Data access requests may be submitted to: Mary Kate Shapley-Quinn (Project Manager, RTI International), mshapley@ 123456rti.org or Chasity Norton (Project Manager, RTI International), cnorton@ 123456rti.org .

                Uncategorized
                Uncategorized

                Comments

                Comment on this article