Africa: Peer Energy – How Youth-Led Outreach Can Remodel PrEP Entry in Tanzania #HIVR4P2024

Margareth Mwakilasa, an assistant analysis fellow at Muhimbili University of Health and Allied Sciences in Tanzania and a PhD scholar in Global Health at University College Dublin, introduced her analysis findings on the fifth HIV Research for Prevention Conference (#HIVR4P2024) in Lima, Peru. Her examine, titled “They are Not HIV Treatment Drugs; They are Preventive Drugs (PrEP): Experiences of Using PrEP Among Vulnerable Adolescent Girls and Young Women in Tanzania,” was a part of the Oral Abstract session “Support Matters: You Are Not Alone!”

Mwakilasa’s analysis targeted on the sensible and social dynamics of PrEP uptake amongst adolescent ladies and younger girls at excessive threat of HIV in Tanzania. Data collected over two years through interviews with 52 members allowed for a deep dive into the boundaries and facilitators impacting PrEP use in institutional settings. In an interview with AllAfrica’s Sethi Ncube, she mentioned her analysis paper, which has been accepted for publication  in PLOS  ONE, a peer-reviewed journal by the Public Library of Science, with anticipated publication in November or December 2024.

In Tanzania, regardless of outstanding advances in HIV prevention, adolescent ladies and younger girls at excessive threat nonetheless face vital boundaries to accessing pre-exposure prophylaxis (PrEP). PrEP is a confirmed intervention that, when taken constantly, can forestall HIV an infection. However, as PrEP is at the moment reserved for key populations, its availability is barely restricted to younger girls recognized as high-risk, together with these with repeated STI historical past, HIV-positive companions, or these engaged in transactional intercourse. This slender entry leaves many younger girls at nighttime about this prevention tool.

Research and conversations with adolescent PrEP customers in Tanzania revealed that though PrEP consciousness is rising amongst these in this system, misinformation and logistical boundaries are impeding widespread entry.

“For these vulnerable adolescent girls and young women, the ones that I’ve had an opportunity to sit down and talk to, there are some who really know what PrEP is and how HIV can be prevented. They have that knowledge. But if you go to a general population right now, if you go to school and ask adolescents or go to a secondary school, I bet you a very small number will have an awareness of what PrEP is and how it works. Also, misconceptions about PrEP are not only within users…what is been discussed within the community is that PrEP is not an HIV prevention drug. Maybe it causes cancer or infertility…,” says Mwakilasa. This hole in consciousness is usually as a result of restricted outreach, as younger individuals usually study PrEP from pals fairly than healthcare suppliers.

To bridge this data hole, Mwakilasa’s examine used artistic recruitment strategies, putting informational flyers and brochures at well being amenities the place eligible adolescent ladies and younger girls return for PrEP refills. Partnering with peer navigators – trusted figures in the neighborhood skilled to share correct well being data — has been a key technique. For many adolescents, talking with a peer about PrEP was more reassuring than talking with a healthcare employee.

Empowering Youth in Healthcare

According to the examine, lengthy wait occasions and a scarcity of healthcare suppliers have an effect on many nations, however increasing peer-led help networks might assist. By coaching extra younger peer educators, we will scale back the burden on healthcare suppliers and improve the adolescent affected person expertise. These peer educators can deal with routine help duties throughout refill appointments, permitting nurses to deal with prescriptions and testing. Additionally, hiring extra younger healthcare professionals can create a extra snug setting for adolescents, encouraging open discussions about delicate matters like reproductive well being and contraception. Expanding each peer and younger supplier roles could make healthcare areas extra welcoming and scale back stigma, empowering adolescents to hunt the care they want.

Operational and Structural Barriers Impacting Consistency

According to Mwakilasa, as soon as younger girls begin on PrEP, maintaining with refills and appointments brings additional challenges. Tanzanian clinics function from 9 to five, hours that overlap with younger individuals’s personal working hours or enterprise actions important for his or her livelihoods. Many adolescents miss their scheduled refill dates or forego PrEP completely, because the transportation prices are too excessive for these residing removed from clinics. While some areas have began utilizing cell clinics to deliver providers nearer to communities, this answer is proscribed to sure areas, and plenty of adolescents are left unsupported.

“The PrEP delivery model varies from region to region, we have some donors who have peer navigators or healthcare providers, or have mobile cars to go on a community service delivery. These are only available in certain areas. I think there are some measures that need to be put into place to consider these issues that adolescents are raising, that they are a challenge for them to be able to access service.”

Privacy points in well being amenities additional deter younger girls from in search of PrEP. With clinics typically situated in seen areas, adolescent ladies and younger girls worry being noticed by neighbours and being judged or labeled as HIV-positive. Moreover, PrEP providers are sometimes housed inside HIV remedy facilities, areas that carry a stigma adolescents and younger girls have grown up cautious of. “Seeing someone I know in the clinic can be uncomfortable,” one participant stated.

She stated separating PrEP providers from HIV remedy areas might create a youth-friendly setting that fosters confidence and luxury in accessing PrEP.

Navigating Misinformation and Enhancing Peer-Led Outreach

The younger girls Mwakilasa interviewed highlighted the necessity for schooling campaigns led by youth voices. Studies present adolescents usually tend to belief PrEP data delivered by their friends than by unfamiliar and older healthcare staff. Training peer educators with complete PrEP data and equipping them with informational supplies might considerably increase outreach. Community-based PrEP packages might additionally supply sensible options. Adolescents envision cell items stationed in acquainted spots, like group facilities, the place they will discreetly decide up refills with out being within the public eye.

Community-based campaigns led by peer educators might clear up dangerous misconceptions, and construct consciousness that PrEP is a safe, preventive tool, not treatment. PrEP supply by way of group facilities and partnerships with native leaders might additionally create protected areas the place younger girls really feel snug in search of care.