Katy Todd, FHI 360
Elizabeth Irungu, Jhpiego
This post is part of a five-part series about the strategic priorities of the Maximizing Options to Advance Informed Choice for HIV Prevention (MOSAIC) project.
When countries introduce novel HIV prevention products, such as the PrEP ring and injectable CAB PrEP, how will women decide which product to use, and what will influence those decisions? How will the availability of multiple methods affect pre-exposure prophylaxis (PrEP) uptake, continuation, and patterns of use, particularly among young women and adolescent girls? And what kind of support do potential users and health care providers need to ensure informed choice and effective use?
These are just some of the questions the MOSAIC project aims to answer over the next few years. We will do so through a robust portfolio of research activities designed to expand the global evidence base for PrEP policies and programs and, ultimately, improve PrEP product use and choice among women in sub-Saharan Africa.
The foundation of this research will be a product introduction study MOSAIC will conduct in several countries to gain a better understanding of how women use and want to use PrEP products, the barriers to use, and the best approaches to supporting effective use. To allow comparisons across countries, we will work closely with national health authorities, U.S. Agency for International Development (USAID) missions, donors, other researchers, and product developers to select common outcome measures.
The MOSAIC PrEP introduction study will also provide opportunities to evaluate demand generation and user support interventions and apply findings and lessons from previous research and programs, as well as new indicators to better capture PrEP use and thus more accurately forecast demand.
Mary Mugambi, a PrEP manager with the Kenya National AIDS and STIs Control Programme, says that introduction studies are needed in Kenya and other countries where the PrEP ring has been registered, “to inform us on the subpopulation of young women who are interested in the ring and their uptake patterns. This is important for us, to know the demand and also how to target.” MOSAIC will address this need for evidence, which also extends to CAB PrEP and other novel PrEP products, in collaboration with government and civil society stakeholders as new products are introduced.
To explore PrEP product values and preferences, MOSAIC will conduct human-centered design discussions with potential users and with providers and other key influencers, addressing products in the development pipeline as well as those poised to enter the market. This work will focus on the values and preferences of women, with special emphasis on adolescent girls and young women, female sex workers, and pregnant and breastfeeding people.
All MOSAIC research will “begin with the end in mind” — that is, it will be designed and implemented to optimize the use of study findings in program delivery. We are excited about the potential impact of this research. Working closely with the MOSAIC team implementing another strategic priority — research utilization — we will generate evidence to help countries improve the availability, acceptability, uptake, and effective use of PrEP products among women.
Featured Image: International Partnership for Microbicides
Featured Graphic: Aubrey Weber/FHI 360