Project description
HIV prevention in mobile men in Sub-Saharan Africa
HIV prevention research in Africa has focused on young women. However, heterosexual men, vulnerable due to their mobility, remain a priority. Long-acting injectable cabotegravir (CAB-LA) and on-demand oral pre-exposure prophylaxis (PrEP) have not yet been evaluated in this population. The EU-funded MOBILE MEN project will investigate the requirement among men for on-demand PrEP and CAB-LA. Using the RE-AIM framework and rapid assessment, the project will gather evidence for potential guideline changes, inform scalability, and provide operational tools for PrEP implementation. It will also examine factors influencing mobile men’s uptake of new PrEP options and assess the effectiveness of implementing these options through a study involving 400 men from mobile groups in South Africa and Uganda.
Objective
Reducing HIV is key 2030 SDG target. In Africa, HIV prevention research has focused on young women yet heterosexual men, vulnerable due to their mobility, remain WHO priority. Long-acting injectable cabotegravir (CAB-LA) and on-demand, oral pre-exposure prophylaxis (PrEP) have not been evaluated in such men who are not in-line to receive either.
Building on our EU studies men want on-demand PrEP and CAB-LA (referred to as new PrEP options). This project using RE-AIM framework (Reach, Effectiveness, Adoption, Implementation and Maintenance), uses rapid assessment followed by implementation trial.
Objectives
1: Catalysts/barriers across local and regional contexts that could influence uptake of new PrEP options by mobile men
a. Qualitative assessment mobility patterns of men, knowledge/ perceptions of PrEP effectiveness
b. Policy analysis at local and national level
2: Assess implementation effectiveness of new PrEP options by comparison of retention in care, effective use and expressed choice
Open-label study of 400 men from mobile groups in South Africa and Uganda randomised to oral TDF-FTC or CAB-LA over 9 months, then access to both to 18months
3: Preferences of mobile men amongst new PrEP options
a. Adoption of new PrEP options
b. Barriers in non PrEP acceptors
c. Patterns of PrEP use
d. Participant/ staff / community reflections
4: Reach and implementation of PrEP for mobile men amongst service providers to inform scale-up
a. Reach of PrEP
b. Feasibility of delivering PrEP in different settings
c. Fidelity of PrEP delivery in practice
d. Service-level needs and adaptations to implement PrEP
Objectives 3 and 4 use mixed methods in users and service providers.
Objective 5: Affordability, cost and cost effectiveness of new PrEP options using HIV synthesis model
This first multi-country study of on-demand PrEP and CAB-LA in men in Africa provides evidence for guidelines change, inform scalability, and provide operational tools for PrEP implementation.
Fields of science
CORDIS classifies projects with EuroSciVoc, a multilingual taxonomy of fields of science, through a semi-automatic process based on NLP techniques.
CORDIS classifies projects with EuroSciVoc, a multilingual taxonomy of fields of science, through a semi-automatic process based on NLP techniques.
Keywords
Programme(s)
- HORIZON.2.1 - Health Main Programme
Funding Scheme
HORIZON-JU-RIA - HORIZON JU Research and Innovation ActionsCoordinator
7925 Cape Town
South Africa