Omar Sued

In this session, 6 experiences from all over the world addressed the experiences and challenges when working with communities to roll out PrEP

A qualitative study in Kenya evaluated perceptions of healthcare workers (HCWs) about the integration of PrEP programs with mother-to-child programs and family planning clinics. PrEP was seen as acceptable and feasible, and the increased workload was the main concern. Another qualitative study in Kenya demonstrates that HCWs valued allowing local guideline adaptations and discussing innovative modifications to patient flows and routines to reduce barriers for clients and staff. Similar challenges were identified in Thailand, where acceptability is high but many HCWs requested more training. In the US, a survey of 271 nurses demonstrated they could prescribe PrEP but more training is needed. The attitudes about PrEP were evaluated in the SEARCH trial (Uganda and Kenya) unveiling positive but also negative attitudes such as moral concerns and worry over seroconversions. Existing provider networks could be leveraged for support with navigating patient-provider interactions and community perceptions of PrEP.

Most of these qualitative studies demonstrate the need to made local adaptations to service provision models and guidelines to facilitate PrEP implementation. These experiences might inform other implementation efforts. Specific concerns include how to deal with the stigma in the community and, how to engage adolescents, not only as users but also in the roll-out of PrEP.