Engaging the private sector as part of HIV pre-exposure prophylaxis service delivery in Vietnam: a comparative analysis of uptake, persistence and HIV seroconversion from 2018 to 2023
BackgroundIn Vietnam, PrEP was introduced in 2017 and scaled up from 2019. Private sector engagement (PSE) in PrEP service delivery was deployed as a strategy from the start to increase PrEP access. We assessed the effectiveness of this approach to inform ongoing efforts to accelerate epidemic contr...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Reproductive Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/frph.2024.1439461/full |
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| author | Bao Ngoc Vu Kimberly Green Huong Phan Long Tran Phuong Phan Tham Tran Linh Doan Yen Vu Chau Pham Dao Nguyen Anh Doan Trang Ngo Phuong Tran Vuong Nguyen Bieu Nguyen Thai Phan Ha Nguyen |
| author_facet | Bao Ngoc Vu Kimberly Green Huong Phan Long Tran Phuong Phan Tham Tran Linh Doan Yen Vu Chau Pham Dao Nguyen Anh Doan Trang Ngo Phuong Tran Vuong Nguyen Bieu Nguyen Thai Phan Ha Nguyen |
| author_sort | Bao Ngoc Vu |
| collection | DOAJ |
| description | BackgroundIn Vietnam, PrEP was introduced in 2017 and scaled up from 2019. Private sector engagement (PSE) in PrEP service delivery was deployed as a strategy from the start to increase PrEP access. We assessed the effectiveness of this approach to inform ongoing efforts to accelerate epidemic control by 2030.MethodsWe implemented a process evaluation with longitudinal design using retrospective programmatic data collected and uploaded onto a secure online system (HMED) from 23 public and 17 private PrEP clinics in Hanoi, Ho Chi Minh City (HCMC), and Dong Nai. We measured the effectiveness of PrEP service delivery by PrEP initiation/reinitiation, uptake, persistence, discontinuation, and HIV seroconversion. We used the Kaplan-Meier time-to-event approach to estimate PrEP persistence and mixed-effects logistic regression analysis to assess factors associated with the PrEP persistence.ResultsFrom October 2017 to September 2023, 29,944 individuals initiated PrEP, and among these, 79.3% started PrEP at a private sector clinic while 20.7% initiated in a public sector clinic. The median duration of PrEP use persistence at private clinics was significantly longer than that at public clinics (268 days vs. 148 days, respectively). Mixed-effects logistic regression analysis results indicated a significant statistical association between PrEP persistence for at least three months and initiating PrEP at a private clinic [adjusted odds ratio [aOR] = 4.28; 95% confidence interval [CI]: 2.96–6.19], opting for TelePrEP (aOR = 3.42; 95% CI: 2.12–5.53), or being 20 years of age or older (aOR = 1.86; 95% CI: 1.62–2.13). HIV seroconversion was significantly lower among PrEP users at private clinics compared to public clinics (0.03 vs. 0.13 per 100 person-years, respectively; p < 0.01).ConclusionOffering choice in PrEP service delivery options is essential to increase access and uptake. Private-sector PrEP providers play a pivotal role in increasing PrEP uptake and coverage in Vietnam, and will be critical to delivery of new long-acting options. |
| format | Article |
| id | doaj-art-b344faa026734e50bb1bdd0adbf0a502 |
| institution | Kabale University |
| issn | 2673-3153 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Reproductive Health |
| spelling | doaj-art-b344faa026734e50bb1bdd0adbf0a5022025-01-21T08:36:48ZengFrontiers Media S.A.Frontiers in Reproductive Health2673-31532025-01-01610.3389/frph.2024.14394611439461Engaging the private sector as part of HIV pre-exposure prophylaxis service delivery in Vietnam: a comparative analysis of uptake, persistence and HIV seroconversion from 2018 to 2023Bao Ngoc Vu0Kimberly Green1Huong Phan2Long Tran3Phuong Phan4Tham Tran5Linh Doan6Yen Vu7Chau Pham8Dao Nguyen9Anh Doan10Trang Ngo11Phuong Tran12Vuong Nguyen13Bieu Nguyen14Thai Phan15Ha Nguyen16Southeast Asia Hub, PATH, Hanoi, VietnamSoutheast Asia Hub, PATH, Hanoi, VietnamMinistry of Health, Vietnam Administration of HIV/AIDS Control, Hanoi, VietnamSoutheast Asia Hub, PATH, Hanoi, VietnamSoutheast Asia Hub, PATH, Hanoi, VietnamSoutheast Asia Hub, PATH, Hanoi, VietnamMinistry of Health, Vietnam Administration of HIV/AIDS Control, Hanoi, VietnamSoutheast Asia Hub, PATH, Hanoi, VietnamSoutheast Asia Hub, PATH, Hanoi, VietnamOffice of Health, United States Agency for International Development (Vietnam), Hanoi, VietnamOffice of Health, United States Agency for International Development (Vietnam), Hanoi, VietnamOffice of Health, United States Agency for International Development (Vietnam), Hanoi, VietnamSoutheast Asia Hub, PATH, Ho Chi Minh City, VietnamSoutheast Asia Hub, PATH, Ho Chi Minh City, VietnamSoutheast Asia Hub, PATH, Hanoi, VietnamSoutheast Asia Hub, PATH, Ho Chi Minh City, VietnamSoutheast Asia Hub, PATH, Hanoi, VietnamBackgroundIn Vietnam, PrEP was introduced in 2017 and scaled up from 2019. Private sector engagement (PSE) in PrEP service delivery was deployed as a strategy from the start to increase PrEP access. We assessed the effectiveness of this approach to inform ongoing efforts to accelerate epidemic control by 2030.MethodsWe implemented a process evaluation with longitudinal design using retrospective programmatic data collected and uploaded onto a secure online system (HMED) from 23 public and 17 private PrEP clinics in Hanoi, Ho Chi Minh City (HCMC), and Dong Nai. We measured the effectiveness of PrEP service delivery by PrEP initiation/reinitiation, uptake, persistence, discontinuation, and HIV seroconversion. We used the Kaplan-Meier time-to-event approach to estimate PrEP persistence and mixed-effects logistic regression analysis to assess factors associated with the PrEP persistence.ResultsFrom October 2017 to September 2023, 29,944 individuals initiated PrEP, and among these, 79.3% started PrEP at a private sector clinic while 20.7% initiated in a public sector clinic. The median duration of PrEP use persistence at private clinics was significantly longer than that at public clinics (268 days vs. 148 days, respectively). Mixed-effects logistic regression analysis results indicated a significant statistical association between PrEP persistence for at least three months and initiating PrEP at a private clinic [adjusted odds ratio [aOR] = 4.28; 95% confidence interval [CI]: 2.96–6.19], opting for TelePrEP (aOR = 3.42; 95% CI: 2.12–5.53), or being 20 years of age or older (aOR = 1.86; 95% CI: 1.62–2.13). HIV seroconversion was significantly lower among PrEP users at private clinics compared to public clinics (0.03 vs. 0.13 per 100 person-years, respectively; p < 0.01).ConclusionOffering choice in PrEP service delivery options is essential to increase access and uptake. Private-sector PrEP providers play a pivotal role in increasing PrEP uptake and coverage in Vietnam, and will be critical to delivery of new long-acting options.https://www.frontiersin.org/articles/10.3389/frph.2024.1439461/fullHIV preventionpre-exposure prophylaxisprivate sector engagementkey populationsVietnam |
| spellingShingle | Bao Ngoc Vu Kimberly Green Huong Phan Long Tran Phuong Phan Tham Tran Linh Doan Yen Vu Chau Pham Dao Nguyen Anh Doan Trang Ngo Phuong Tran Vuong Nguyen Bieu Nguyen Thai Phan Ha Nguyen Engaging the private sector as part of HIV pre-exposure prophylaxis service delivery in Vietnam: a comparative analysis of uptake, persistence and HIV seroconversion from 2018 to 2023 Frontiers in Reproductive Health HIV prevention pre-exposure prophylaxis private sector engagement key populations Vietnam |
| title | Engaging the private sector as part of HIV pre-exposure prophylaxis service delivery in Vietnam: a comparative analysis of uptake, persistence and HIV seroconversion from 2018 to 2023 |
| title_full | Engaging the private sector as part of HIV pre-exposure prophylaxis service delivery in Vietnam: a comparative analysis of uptake, persistence and HIV seroconversion from 2018 to 2023 |
| title_fullStr | Engaging the private sector as part of HIV pre-exposure prophylaxis service delivery in Vietnam: a comparative analysis of uptake, persistence and HIV seroconversion from 2018 to 2023 |
| title_full_unstemmed | Engaging the private sector as part of HIV pre-exposure prophylaxis service delivery in Vietnam: a comparative analysis of uptake, persistence and HIV seroconversion from 2018 to 2023 |
| title_short | Engaging the private sector as part of HIV pre-exposure prophylaxis service delivery in Vietnam: a comparative analysis of uptake, persistence and HIV seroconversion from 2018 to 2023 |
| title_sort | engaging the private sector as part of hiv pre exposure prophylaxis service delivery in vietnam a comparative analysis of uptake persistence and hiv seroconversion from 2018 to 2023 |
| topic | HIV prevention pre-exposure prophylaxis private sector engagement key populations Vietnam |
| url | https://www.frontiersin.org/articles/10.3389/frph.2024.1439461/full |
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