Assessing Physical Delivery of PrEP in Support of Proof of Deliverability

This project, implemented in Nakuru and Nairobi, Kenya and KwaZulu-Natal in South Africa focused on identifying the most feasible and acceptable channels for the delivery of a variety of ARV- based prevention products to populations at high risk of HIV infection, evaluating the impact of delivering these products on existing health services and identifying the additional capacity required to support product introduction. A range of ARV-based HIV prevention technologies, including oral PrEP, vaginal microbicides, and an injectable form of PrEP were explored. In-depth interviews were conducted with stakeholders and focus groups were convened with potential end-user groups including adolescent/young women, female sex workers and discordant couples). Quantitative facility assessments were also conducted in 15 facilities and a stakeholder consultation meeting was conducted in Kenya. Delivery channels for female sex workers included sex-worker focused NGO services and public-sector primary health care facilities; comprehensive care centers and public-sector family planning services were identified for discordant couples. Channels for young women included public-sector primary health care and family planning services. Participants stressed the importance of having products available in multiple settings to increase access, support adherence and address concerns over privacy, convenience and quality of care. Concern for increasing wait time, staffing shortages and client flow were common. Provider training and sensitization, additional staffing, client education and improvements to health systems such as client tracking, stock forecasting and referral systems were noted as important for successful product provision. (Completed December 2012)