How PrEP delivery was integrated into public ART clinics in central Uganda: A qualitative analysis of implementation processes

Simple item page
dc.contributor.authorWyatt, Monique A
dc.contributor.authorPisarski, Emily E
dc.contributor.authorNalumansi, Alisaati
dc.contributor.authorKasiita, Vicent
dc.contributor.authorKamusiime, Brenda
dc.contributor.authorNalukwago, Grace K
dc.contributor.authorThomas, Dorothy
dc.contributor.authorMuwonge, Timothy R
dc.contributor.authorMujugira, Andrew
dc.contributor.authorHeffron, Renee
dc.contributor.authorWare, Norma C
dc.date.accessioned2024-03-12T07:48:03Z
dc.date.available2024-03-12T07:48:03Z
dc.date.issued2024-03-07
dc.description.abstractTailored delivery strategies are important for optimizing the benefit and overall reach of PrEP in sub-Saharan Africa. An integrated approach of delivering time-limited PrEP in combination with ART to serodifferent couples encourages PrEP use in the HIV-negative partner as a bridge to sustained ART use. Although PrEP has been delivered in ART clinics for many years, the processes involved in integrating PrEP into ART services are not well understood. The Partners PrEP Program was a stepped-wedge cluster randomized trial of integrated PrEP and ART delivery for HIV serodifferent couples in 12 public health facilities in central Uganda (Clinicaltrials.gov NCT03586128). Using qualitative data, we identified and characterized key implementation processes that explain how PrEP delivery was integrated into existing ART services in the Partners PrEP Program. In-depth interviews were conducted with a purposefully-selected sub-sample of 83 members of 42 participating serodifferent couples, and with 36 health care providers implementing integrated delivery. High quality training, technical supervision, and teamwork were identified as key processes supporting providers to implement PrEP delivery. Interest in the PrEP program was promoted through the numerous ways health care providers made integrated ART and PrEP meaningful for serodifferent couples, including tailored counseling messages, efforts to build confidence in integrated delivery, and strategies to create demand for PrEP. Couples in the qualitative sample responded positively to providers’ efforts to promote the integrated strategy. HIV-negative partners initiated PrEP to preserve their relationships, which inspired their partners living with HIV to recommit to ART adherence. Lack of disclosure among couples and poor retention on PrEP were identified as barriers to implementation of the PrEP program. A greater emphasis on understanding the meaning of PrEP for users and its contribution to implementation promises to strengthen future research on PrEP scale up in sub-Saharan Africa.en_US
dc.description.sponsorshipThis work was supported by the National Institute of Mental Health (R01MH110296 to RH). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.en_US
dc.identifier.citationWyatt, Monique A., Emily E. Pisarski, Alisaati Nalumansi, et al. 'How PrEP Delivery was Integrated into Public ART Clinics in Central Uganda: A Qualitative Analysis of Implementation Processes', PLOS Global Public Health, vol. 4/no. 3, (2024), pp. e0002916.en_US
dc.identifier.issnEISSN 2767-3375
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/9428
dc.language.isoenen_US
dc.publisherPublic Library of Scienceen_US
dc.subjectHIV; Antiretroviral therapy ; Pre-exposure prophylaxis; Health care facilities; Health care providers; Uganda; Public and occupational health; HIV preventionen_US
dc.titleHow PrEP delivery was integrated into public ART clinics in central Uganda: A qualitative analysis of implementation processesen_US
dc.typeArticleen_US
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
journal.pgph.0002916.pdf
Size:
532.18 KB
Format:
Adobe Portable Document Format
Description:
Journal Article
Download
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.71 KB
Format:
Item-specific license agreed upon to submission
Description:
Download
Collections
Medical and Health Sciences