Outcomes of a community-based HIV-prevention pilot programme for township men who have sex with men in Cape Town, South Africa

Abstract Background Daily doses of pre-exposure prophylaxis (PrEP) can reduce the risk of acquiring HIV by more than 95 %. In sub-Saharan Africa, adolescent girls and young women (AGYW) are at disproportionately high risk of acquiring HIV, accounting for 25 % of new infections. There are limited data available on implementation approaches to effectively reach and deliver PrEP to AGYW in high HIV burden communities. Methods We explored the feasibility and acceptability of providing PrEP to AGYW (aged 16–25 years) via a community-based mobile health clinic (CMHC) known as the Tutu Teen Truck (TTT) in Cape Town, South Africa. The TTT integrated PrEP delivery into its provision of comprehensive sexual and reproductive health services (SRHS). We analyzed data from community meetings and in-depth interviews with 30 AGYW PrEP users to understand the benefits and challenges of PrEP delivery in this context. Results A total of 585 young women started PrEP at the TTT between July 2017 – October 2019. During in-depth interviews a subset of 30 AGYW described the CMHC intervention for PrEP delivery as acceptable and accessible. The TTT provided services at times and in neighborhood locations where AGYW organically congregate, thus facilitating service access and generating peer demand for PrEP uptake. The community-based nature of the CMHC, in addition to its adolescent friendly health providers, fostered a trusting provider-community-client relationship and strengthened AGYW HIV prevention self-efficacy. The integration of PrEP and SRHS service delivery was highly valued by AGYW. While the TTT’s integration in the community facilitated acceptability of the PrEP delivery model, challenges faced by the broader community (community riots, violence and severe weather conditions) also at times interrupted PrEP delivery. Conclusions PrEP delivery from a CMHC is feasible and acceptable to young women in South Africa. However, to effectively scale-up PrEP it will be necessary to develop diverse PrEP delivery locations and modalities to meet AGYW HIV prevention needs.

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Anti-retroviral Therapy Based HIV Prevention Among a Sample of Men Who Have Sex with Men in Cape Town, South Africa: Use of Post-exposure Prophylaxis and Knowledge on Pre-exposure Prophylaxis

AIDS and Behavior ◽

10.1007/s10461-016-1536-1 ◽

2016 ◽

Vol 20 (S3) ◽

pp. 357-364 ◽

Cited By ~ 6

Author(s):

J. M. Hugo ◽

R. D. Stall ◽

K. Rebe ◽

J. E. Egan ◽

G. De Swardt ◽

...

Keyword(s):

South Africa ◽

Hiv Prevention ◽

Cape Town ◽

Post Exposure Prophylaxis ◽

Post Exposure ◽

Sex With Men ◽

Exposure Prophylaxis

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‘Break the Chains 2015’ community-based HIV prevention campaign for men who have sex with men in Switzerland: non-randomised evaluation and cost analysis

BMJ Open ◽

10.1136/bmjopen-2019-032459 ◽

2020 ◽

Vol 10 (1) ◽

pp. e032459

Author(s):

Kathrin Frey ◽

Stéphanie Lociciro ◽

Patricia Blank ◽

Matthias Schwenkglenks ◽

Françoise Dubois-Arber ◽

...

Keyword(s):

At Risk ◽

Hiv Prevention ◽

Cost Analysis ◽

Hiv Testing ◽

Community Based ◽

Prevention Campaign ◽

Sex With Men ◽

Hiv Acquisition ◽

Risk Of Hiv Acquisition ◽

Campaign Message

ObjectivesTo study the implementation, effects and costs of Break the Chains, a community-based HIV prevention campaign for men who have sex with men (MSM) in Switzerland, from March to May 2015, which aimed to reduce early HIV transmission by promoting the campaign message to adopt short-term risk reduction followed by HIV testing.DesignNon-randomised evaluation and cost analysis.SettingGay venues in 11 of 26 cantons in Switzerland and national online media campaign.ParticipantsMSM in online surveys (precampaign n=834, postcampaign n=688) or attending HIV testing centres (n=885); campaign managers (n=9); and campaign staff (n=38) or further intermediaries (n=80) in an online survey.Primary and secondary outcome measuresThe primary outcome measure was the proportion of MSM at risk of HIV acquisition or transmission who adhered to the campaign message. Secondary outcomes were postcampaign test uptake, knowledge about HIV primary infection and sense of belonging to the gay community.ResultsCampaign staff estimated that they contacted 17 145 MSM in 11 cantons. Among 688 respondents to the postcampaign survey, 311 (45.2%) were categorised as MSM at risk. Of 402/688 (58.5%) MSM who had heard about Break the Chains 2015, MSM categorised as being at risk were less likely to report adherence to the campaign message than MSM not at risk (adjusted OR 0.24; 95% CI 0.14 to 0.42). Twenty per cent of MSM with a defined risk of HIV acquisition or transmission who adopted risk reduction declared having done so because of the campaign. Costs for one MSM at risk to adhere to the campaign message were estimated at USD purchasing power parity 36–55. The number of HIV tests in the month after the campaign was twice the monthly average.ConclusionBreak the Chains increased HIV testing, implying that community-based campaigns are useful HIV prevention strategies for MSM. Additional interventions are needed to reach MSM at the highest risk of infection more effectively.

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Factors associated with linkage to HIV care and TB treatment at community-based HIV testing services in Cape Town, South Africa

PLoS ONE ◽

10.1371/journal.pone.0195208 ◽

2018 ◽

Vol 13 (4) ◽

pp. e0195208 ◽

Cited By ~ 6

Author(s):

Sue-Ann Meehan ◽

Rosa Sloot ◽

Heather R. Draper ◽

Pren Naidoo ◽

Ronelle Burger ◽

...

Keyword(s):

South Africa ◽

Hiv Testing ◽

Cape Town ◽

Hiv Care ◽

Community Based ◽

Factors Associated ◽

Tb Treatment ◽

Hiv Testing Services ◽

Linkage To Hiv Care

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Knowledge, attitudes and practices of young adults towards HIV prevention: an analysis of baseline data from a community-based HIV prevention intervention study in two high HIV burden districts, South Africa

BMC Public Health ◽

10.1186/s12889-020-09356-3 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Simukai Shamu ◽

Sikhulile Khupakonke ◽

Thato Farirai ◽

Jean Slabbert ◽

Thato Chidarikire ◽

...

Keyword(s):

South Africa ◽

Young Adults ◽

Hiv Prevention ◽

Intervention Study ◽

Baseline Data ◽

Community Based ◽

Prevention Intervention ◽

Hiv Prevention Intervention ◽

Attitudes And Practices ◽

Knowledge Attitudes And Practices

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“It’s natural to look for a source”: A qualitative examination of alternative beliefs about HIV and AIDS in Cape Town, South Africa

Public Understanding of Science ◽

10.1177/0963662515611823 ◽

2015 ◽

Vol 26 (3) ◽

pp. 369-384 ◽

Cited By ~ 3

Author(s):

Clara Rubincam

Keyword(s):

South Africa ◽

Hiv Prevention ◽

Focus Group ◽

Scientific Evidence ◽

Cape Town ◽

Hiv And Aids ◽

Men And Women ◽

Street Level ◽

Outright Rejection ◽

Past Experiences

This article highlights how African men and women in South Africa account for the plausibility of alternative beliefs about the origins of HIV and the existence of a cure. This study draws on the notion of a “street-level epistemology of trust”—knowledge generated by individuals through their everyday observations and experiences—to account for individuals’ trust or mistrust of official claims versus alternative explanations about HIV and AIDS. Focus group respondents describe how past experiences, combined with observations about the power of scientific developments and perceptions of disjunctures in information, fuel their uncertainty and skepticism about official claims. HIV prevention campaigns may be strengthened by drawing on experiential aspects of HIV and AIDS to lend credibility to scientific claims, while recognizing that some doubts about the trustworthiness of scientific evidence are a form of skeptical engagement rather than of outright rejection.

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