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Implementing oral and long acting Pre-exposure prophylaxis in mobile men in Sub-Saharan Africa [MOBILE MEN]

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.

Programme(s)

Coordinator

DESMOND TUTU HEALTH FOUNDATION NPC
Net EU contribution
€ 1 028 246,25
Address
3 WOODLANDS ROAD WOODSTOCK
7925 Cape Town
South Africa

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Activity type
Other
Links
Total cost
€ 1 028 246,25

Participants (7)