Service delivery models that promote linkages to PrEP for adolescent girls and young women and men in sub-Saharan Africa: a scoping review.
Trisha RamrajWitness ChirindaKim JonasDarshini GovindasamyNgcwalisa JamaTracy McClinton AppollisBabalwa ZaniFerdinand C MukumbangWisdom BaseraMbuzeleni HlongwaEunice B TurawaCatherine MathewsEdward NicolPublished in: BMJ open (2023)
Of the 1204 identified records, 37 (met the inclusion criteria. Health facility-based integrated models of PrEP delivery with family planning, maternal and child health or sexual and reproductive services to AGYW resulted in PrEP initiation of 16%-90%. Community-based drop-in centres (66%) was the preferred PrEP outlet for AGYW compared with public clinics (25%) and private clinics (9%). Most men preferred community-based delivery models. Among individuals who initiated PrEP, 50% were men, 62% were <35 years old and 97% were tested at health fairs compared with home testing. Integrated antiretroviral therapy (ART)-PrEP delivery was favoured among serodiscordant couples with 82.9% of couples using PrEP or ART with no HIV seroconversions. PrEP initiation within healthcare facilities was increased by perceived client-friendly services and non-judgemental healthcare workers. Barriers to PrEP initiation included distance to travel to and time spent at health facilities and perceived community stigma. PrEP SDMs for AGYW and men need to be tailored to the needs and preferences for each group. Programme implementers should promote community-based SDMs to increase PrEP initiation among AGYW and men.
Keyphrases
- men who have sex with men
- healthcare
- hiv positive
- mental health
- hiv testing
- antiretroviral therapy
- primary care
- hiv infected
- public health
- depressive symptoms
- human immunodeficiency virus
- social support
- hiv aids
- physical activity
- risk assessment
- tyrosine kinase
- human health
- birth weight
- preterm birth
- weight loss
- climate change
- affordable care act