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PrEParing Family Planning Clinics to Streamline Integration of HIV Prevention Services for Young Women in Kenya

Phase 4
Recruiting
Conditions
HIV Infections
Contraception
STI
Interventions
Drug: PrEP
Registration Number
NCT04666792
Lead Sponsor
University of Washington
Brief Summary

This a prospective, open-label implementation project to catalyze integration of HIV prevention and PrEP care services for adolescent girls and young women in family planning clinics in Kenya.

Detailed Description

Investigators will conduct a stepped-wedge cluster-randomized programmatic project to integrate PrEP provision within a combination HIV prevention package in 12 family planning clinics in Kisumu, Kenya- a region with an HIV prevalence of up to 28% among young women. The project will optimize and sustain PrEP delivery with existing family planning staff, supported through training and ongoing technical assistance. The investigators will rigorously evaluate program reach, effectiveness, adoption, implementation, maintenance, and impact using validated implementation science frameworks and how clinics build new efficient delivery systems.

Recruitment & Eligibility

Status
RECRUITING
Sex
Female
Target Recruitment
3600
Inclusion Criteria
  • Female of reproductive age
  • Sexually active
  • Able and willing to provide informed consent
  • HIV negative, according to national HIV testing algorithm
  • Has at least one risk factor for HIV as defined by the Kenya National AIDS and STI Control Program
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Exclusion Criteria
  • Otherwise not eligible based on the above inclusion criteria
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Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
PrEP for HIV-1 uninfected for women accessing family planningPrEPWomen accessing family planning will be assessed for HIV risk and PrEP eligibility. If eligible and willing to initiate PrEP, they will be provided PrEP in accordance with national guidelines as part of their standard of care at the family planning clinic.
Primary Outcome Measures
NameTimeMethod
Proportion of women accessing family planning services who are screened for HIV riskup to 24 months

Measure HIV risk screening completion among women receiving family planning services

Proportion of women accessing family planning services who uptake PrEP for HIV preventionup to 24 months

Measure PrEP initiation among women receiving family planning services

Secondary Outcome Measures
NameTimeMethod
Develop data tools to expand and support delivery of family planning and HIV prevention servicesup to 24 months

Coordinate with key stakeholders to develop and refine data tools and clinical delivery products during project implementation

Proportion of family planning clinics that implement PrEP provisionup to 36 months

Measure number of clinics that provide PrEP

Proportion of targeted providers who are trained and provide PrEPup to 24 months

Measure number of providers in family planning clinics who implement PrEP

Facilitators and barriers to PrEP implementationup to 24 months

Mixed methods assessment of clinic readiness and ability to implement PrEP per protocol

Proportion of women who remain HIV-negativeup to 24 months

Assess HIV status of women receiving family planning services

Programmatic costs of providing PrEP in family planning clinicsup to 24 months

Conduct micro-costing, cost-effectiveness, and budget impact analyses to estimate the programmatic costs of providing PrEP in family planning clinics

Proportion of core PrEP delivery components delivered per protocolup to 24 months

Measure fidelity to PrEP delivery procedures in family planning clinics

PrEP adherence quantified by tenofovir drug levels in bloodup to 24 months

Measure PrEP adherence among women who initiate PrEP

Trial Locations

Locations (1)

Kenyatta National Hospital

🇰🇪

Kisumu, Kenya

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