Developing and evaluating a community‐driven intervention to promote uptake of HIV and contraception services among students enrolled in colleges and universities in Zimbabwe
Abstract Introduction There is a growing appreciation that community‐led interventions are key to sustaining the HIV response and achieving HIV prevention and treatment targets. Together with young people in colleges/universities and Ministry of Health (MOH), we developed and evaluated a student‐led...
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Wiley
2025-06-01
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| Series: | Journal of the International AIDS Society |
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| Online Access: | https://doi.org/10.1002/jia2.26461 |
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| author | Oppah Kuguyo Lindiwe Mancitshana Collin Mangenah Mary K. Tumushime Nancy Ruhode Edward Matsikire Jane Kalweo Fern Terris‐Prestholt Frances M. Cowan Euphemia Lindelwe Sibanda |
| author_facet | Oppah Kuguyo Lindiwe Mancitshana Collin Mangenah Mary K. Tumushime Nancy Ruhode Edward Matsikire Jane Kalweo Fern Terris‐Prestholt Frances M. Cowan Euphemia Lindelwe Sibanda |
| author_sort | Oppah Kuguyo |
| collection | DOAJ |
| description | Abstract Introduction There is a growing appreciation that community‐led interventions are key to sustaining the HIV response and achieving HIV prevention and treatment targets. Together with young people in colleges/universities and Ministry of Health (MOH), we developed and evaluated a student‐led intervention for promoting the uptake of HIV self‐testing (HIVST), post‐exposure prophylaxis (PEP) and emergency contraception (EC) among college/university students. Methods Over 3 months, in biweekly study team meetings, two workshops with students, two meetings with MOH, and a joint workshop with students, MOH and relevant stakeholders, we co‐developed an intervention for peer‐led promotion/distribution of HIVST, PEP, EC and condoms. The agreed intervention was piloted in three Zimbabwean colleges/universities from December 2023 to February 2024. Student peers distributed HIVST and condoms directly, and vouchers for PEP and EC that were redeemed at college/nearby clinics. During co‐development, students strongly preferred peer distribution of all commodities but this was restricted by regulatory requirements for PEP and EC. Peer distributors (n = 14) kept daily audio diaries of their experiences. In‐depth interviews were held with students (n = 18), peer distributors (n = 11) and key informants (n = 12) to explore views/preferences, with participant observations and four focus group discussions to provide additional insights. We determined the intervention development and implementation costs. Results Peer‐led distribution of HIVST, PEP and EC to college/university students was acceptable, feasible, appropriate and generally implemented as intended. PEP and EC acceptability was driven by high HIV and pregnancy risk among students, who had no easy access to services. Of 100 PEP and 257 EC vouchers distributed, 30% and 40% were redeemed, respectively. The main barrier to PEP and EC uptake was moral judgement against premarital sex, which affected female students more. Judgemental health worker attitudes also limited uptake of PEP and EC. EC voucher redemption among female students was lower versus males, aOR = 0.4 (95% CI = 0.2−0.8), p = 0.019. Redemption was also higher at the college where the nearby clinic could be accessed discreetly. Total cost of the intervention per student was $14.57 (cross‐institution range: $7.26−$35.52). Conclusions Student‐led distribution of HIVST, PEP and EC was feasible, acceptable and affordable. Making the intervention more community‐driven according to the 2024 WHO PEP guidelines will likely achieve great impact. |
| format | Article |
| id | doaj-art-d701c7bcccce44b2a4c75c662fc55152 |
| institution | OA Journals |
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| language | English |
| publishDate | 2025-06-01 |
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| series | Journal of the International AIDS Society |
| spelling | doaj-art-d701c7bcccce44b2a4c75c662fc551522025-08-20T02:22:15ZengWileyJournal of the International AIDS Society1758-26522025-06-0128S1n/an/a10.1002/jia2.26461Developing and evaluating a community‐driven intervention to promote uptake of HIV and contraception services among students enrolled in colleges and universities in ZimbabweOppah Kuguyo0Lindiwe Mancitshana1Collin Mangenah2Mary K. Tumushime3Nancy Ruhode4Edward Matsikire5Jane Kalweo6Fern Terris‐Prestholt7Frances M. Cowan8Euphemia Lindelwe Sibanda9Centre for Sexual Health and HIV/AIDS Research (CeSHHAR) Harare ZimbabweCentre for Sexual Health and HIV/AIDS Research (CeSHHAR) Harare ZimbabweCentre for Sexual Health and HIV/AIDS Research (CeSHHAR) Harare ZimbabweDepartment of Global Health and Development London School of Hygiene and Tropical Medicine London UKCentre for Sexual Health and HIV/AIDS Research (CeSHHAR) Harare ZimbabweCentre for Sexual Health and HIV/AIDS Research (CeSHHAR) Harare ZimbabweUNAIDS Zimbabwe Harare ZimbabweUNAIDS Geneva SwitzerlandCentre for Sexual Health and HIV/AIDS Research (CeSHHAR) Harare ZimbabweCentre for Sexual Health and HIV/AIDS Research (CeSHHAR) Harare ZimbabweAbstract Introduction There is a growing appreciation that community‐led interventions are key to sustaining the HIV response and achieving HIV prevention and treatment targets. Together with young people in colleges/universities and Ministry of Health (MOH), we developed and evaluated a student‐led intervention for promoting the uptake of HIV self‐testing (HIVST), post‐exposure prophylaxis (PEP) and emergency contraception (EC) among college/university students. Methods Over 3 months, in biweekly study team meetings, two workshops with students, two meetings with MOH, and a joint workshop with students, MOH and relevant stakeholders, we co‐developed an intervention for peer‐led promotion/distribution of HIVST, PEP, EC and condoms. The agreed intervention was piloted in three Zimbabwean colleges/universities from December 2023 to February 2024. Student peers distributed HIVST and condoms directly, and vouchers for PEP and EC that were redeemed at college/nearby clinics. During co‐development, students strongly preferred peer distribution of all commodities but this was restricted by regulatory requirements for PEP and EC. Peer distributors (n = 14) kept daily audio diaries of their experiences. In‐depth interviews were held with students (n = 18), peer distributors (n = 11) and key informants (n = 12) to explore views/preferences, with participant observations and four focus group discussions to provide additional insights. We determined the intervention development and implementation costs. Results Peer‐led distribution of HIVST, PEP and EC to college/university students was acceptable, feasible, appropriate and generally implemented as intended. PEP and EC acceptability was driven by high HIV and pregnancy risk among students, who had no easy access to services. Of 100 PEP and 257 EC vouchers distributed, 30% and 40% were redeemed, respectively. The main barrier to PEP and EC uptake was moral judgement against premarital sex, which affected female students more. Judgemental health worker attitudes also limited uptake of PEP and EC. EC voucher redemption among female students was lower versus males, aOR = 0.4 (95% CI = 0.2−0.8), p = 0.019. Redemption was also higher at the college where the nearby clinic could be accessed discreetly. Total cost of the intervention per student was $14.57 (cross‐institution range: $7.26−$35.52). Conclusions Student‐led distribution of HIVST, PEP and EC was feasible, acceptable and affordable. Making the intervention more community‐driven according to the 2024 WHO PEP guidelines will likely achieve great impact.https://doi.org/10.1002/jia2.26461community‐drivenHIV preventionPEPself‐caresexual and reproductive healthyoung people |
| spellingShingle | Oppah Kuguyo Lindiwe Mancitshana Collin Mangenah Mary K. Tumushime Nancy Ruhode Edward Matsikire Jane Kalweo Fern Terris‐Prestholt Frances M. Cowan Euphemia Lindelwe Sibanda Developing and evaluating a community‐driven intervention to promote uptake of HIV and contraception services among students enrolled in colleges and universities in Zimbabwe Journal of the International AIDS Society community‐driven HIV prevention PEP self‐care sexual and reproductive health young people |
| title | Developing and evaluating a community‐driven intervention to promote uptake of HIV and contraception services among students enrolled in colleges and universities in Zimbabwe |
| title_full | Developing and evaluating a community‐driven intervention to promote uptake of HIV and contraception services among students enrolled in colleges and universities in Zimbabwe |
| title_fullStr | Developing and evaluating a community‐driven intervention to promote uptake of HIV and contraception services among students enrolled in colleges and universities in Zimbabwe |
| title_full_unstemmed | Developing and evaluating a community‐driven intervention to promote uptake of HIV and contraception services among students enrolled in colleges and universities in Zimbabwe |
| title_short | Developing and evaluating a community‐driven intervention to promote uptake of HIV and contraception services among students enrolled in colleges and universities in Zimbabwe |
| title_sort | developing and evaluating a community driven intervention to promote uptake of hiv and contraception services among students enrolled in colleges and universities in zimbabwe |
| topic | community‐driven HIV prevention PEP self‐care sexual and reproductive health young people |
| url | https://doi.org/10.1002/jia2.26461 |
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