Preparing for HIV Prevention Trials: From Training to Service Delivery-lessons Learned with Long Acting Reversible Contraception (LARC) in Zambia

2014 ◽  
Vol 30 (S1) ◽  
pp. A254-A255
Author(s):  
Mubiana Inambao ◽  
Naeemah Munir ◽  
Kathleen Wu ◽  
Danielle Dang ◽  
Nurilign Ahmed ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Service Delivery ◽  
Lessons Learned ◽  
Prevention Trials ◽  
Long Acting

scholarly journals Metabolism of Long-Acting Rilpivirine Following Intramuscular Injection: HIV Prevention Trials Network Study 076 (HPTN 076)

2020 ◽  
Author(s):  
Herana Kamal Seneviratne ◽  
Joseph Tillotson ◽  
Julie M Lade ◽  
Linda-Gail Bekker ◽  
Sue Li ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Intramuscular Injection ◽  
Prevention Trials ◽  
Long Acting

scholarly journals Implants for HIV prevention in young women: Provider perceptions and lessons learned from contraceptive implant provision

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262043
Author(s):  
Hilton Humphries ◽  
Michele Upfold ◽  
Gethwana Mahlase ◽  
Makhosazana Mdladla ◽  
Tanuja N. Gengiah ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Young Women ◽  
Healthcare Workers ◽  
New Technologies ◽  
Lessons Learned ◽  
Sub Saharan Africa ◽  
Health Technologies ◽  
Contraceptive Implant ◽  
Long Acting ◽  
Roll Out

Preventing new HIV infections, especially amongst young women, is key to ending the HIV epidemic especially in sub-Saharan Africa. Potent antiretroviral (ARV) drugs used as pre-exposure prophylaxis (PrEP) are currently being formulated as long-acting implantable devices, or nanosuspension injectables that release drug at a sustained rate providing protection from acquiring HIV. PrEP as implants (PrEP Implants) offers an innovative and novel approach, expanding the HIV prevention toolbox. Feedback from providers and future users in the early clinical product development stages may identify modifiable characteristics which can improve acceptability and uptake of new technologies. Healthcare workers (HCWs) perspectives and lessons learned during the rollout of contraceptive implants will allow us to understand what factors may impact the roll-out of PrEP implants. We conducted eighteen interviews with HCWs (9 Nurses and 9 Community Healthcare Workers) in rural KwaZulu-Natal, South Africa. HCWs listed the long-acting nature of the contraceptive implant as a key benefit, helping to overcome healthcare system barriers like heavy workloads and understaffing. However, challenges like side effects, migration of the implant, stakeholder buy-in and inconsistent training on insertion and removal hampered the roll-out of the contraceptive implant. For PrEP implants, HCWs preferred long-acting products that were palpable and biodegradable. Our findings highlighted that the characteristics of PrEP implants that are perceived to be beneficial by HCWs may not align with that of potential users, potentially impacting the acceptability and uptake of PrEP implants. Further our data highlight the need for sustained and multi-pronged approaches to training HCWs and introducing new health technologies into communities. Finding a balance between the needs of HCWs that accommodate their heavy workloads, limited resources at points of delivery of care and the needs and preferences of potential users need to be carefully considered in the development of PrEP implants.

Shifting the Paradigm in HIV Prevention and Treatment Service Delivery Toward Differentiated Care for Youth

2019 ◽  
Author(s):  
Vincent Guilamo-Ramos ◽  
Marco Thimm-Kaiser ◽  
Adam Benzekri ◽  
Donna Futterman
Keyword(s):  
United States ◽  
Hiv Prevention ◽  
Service Delivery ◽  
The United States ◽  
Hiv Care ◽  
Health Concern ◽  
Service Needs ◽  
Minority Adolescents ◽  
Prevention And Treatment ◽  
Differentiated Care

Despite significant progress in the fight against HIV/AIDS in the United States, HIV prevention and treatment disparities among key populations remain a national public health concern. While new HIV diagnoses are increasing among people under age 30—in particular among racial, ethnic, and sexual minority adolescents and young adults (AYA)—dominant prevention and treatment paradigms too often inadequately consider the unique HIV service needs of AYA. To address this gap, we characterize persistent and largely overlooked AYA disparities across the HIV prevention and treatment continuum, identify AYA-specific limitations in extant resources for improving HIV service delivery in the United States, and propose a novel AYA-centered differentiated care framework adapted to the unique ecological and developmental factors shaping engagement, adherence, and retention in HIV services among AYA. Shifting the paradigm for AYA to differentiated HIV care is a promising approach that warrants implementation and evaluation as part of reinforced national efforts to end the HIV epidemic in the United States by 2030.

scholarly journals Venue-Based Recruitment of Women at Elevated Risk for HIV: An HIV Prevention Trials Network Study

2014 ◽  
Vol 23 (6) ◽  
pp. 541-551 ◽  
Author(s):  
Danielle F. Haley ◽  
Carol Golin ◽  
Wafaa El-Sadr ◽  
James P. Hughes ◽  
Jing Wang ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Elevated Risk ◽  
Prevention Trials

Implementing post-trial access plans for HIV prevention research

2018 ◽  
Vol 44 (5) ◽  
pp. 354-358 ◽  
Author(s):  
Amy Paul ◽  
Maria W Merritt ◽  
Jeremy Sugarman
Keyword(s):  
Hiv Prevention ◽  
Large Scale ◽  
Healthcare Systems ◽  
System Level ◽  
Planning Under Uncertainty ◽  
Work Related ◽  
Prevention Trials ◽  
Practical Experiences ◽  
Post Trial ◽  
Local Healthcare

Ethics guidance increasingly recognises that researchers and sponsors have obligations to consider provisions for post-trial access (PTA) to interventions that are found to be beneficial in research. Yet, there is little information regarding whether and how such plans can actually be implemented. Understanding practical experiences of developing and implementing these plans is critical to both optimising their implementation and informing conceptual work related to PTA. This viewpoint is informed by experiences with developing and implementing PTA plans for six large-scale multicentre HIV prevention trials supported by the HIV Prevention Trials Network. These experiences suggest that planning and implementing PTA often involve challenges of planning under uncertainty and confronting practical barriers to accessing healthcare systems. Even in relatively favourable circumstances where a tested intervention medication is approved and available in the local healthcare system, system-level barriers can threaten the viability of PTA plans. The aggregate experience across these HIV prevention trials suggests that simply referring participants to local healthcare systems for PTA will not necessarily result in continued access to beneficial interventions for trial participants. Serious commitments to PTA will require additional efforts to learn from future approaches, measuring the success of PTA plans with dedicated follow-up and further developing normative guidance to help research stakeholders navigate the complex practical challenges of realising PTA.

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