Online Program

Gender-Specific Combination HIV Prevention: Baseline Results from the MP3 Youth Pilot Study

Sunday, November 1, 2015

Ann Kurth, PhD, NYUCN Global, New York University College of Nursing, New York, NY
Jasmine Buttolph, MPH, New York University, New York, NY
Irene Inwani, MD, MPH, University of Nairobi, University of Nairobi, Nairobi, Kenya
Kawango Agot, PhD, MPH, Impact Research and Development Organization, Kisumu, Kenya
Charles M Cleland, PhD, NYU College of Nursing, New York University, New York City, NY
Ruth Nduati, MBChB, MMed, MPH, Department of Pediatrics & Child Health, University of Nairobi, Nairobi, Kenya
James Kiarie, MBChB, MMed, MPH, Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya
Eunice Omanga, PhD, Impact Research and Development Organization, Kisumu, Kenya
Background: Female and male youth (ages 15-24) in sub-Saharan Africa are disproportionately at risk of contracting HIV compared to adults. The MP3 Youth pilot study in Kenya delivers a combination HIV prevention package of evidence-based, gender-specific primary prevention interventions in mobile-health settings. We report baseline results.   

Methods:  The MP3 Youth package includes effective combination HIV prevention interventions for female and male youth, identified through focus groups, systematic review, and modeling. All youth: HIV Counseling and Testing, condoms and facilitated linkage to care for HIV+; For males: medical male circumcision (MMC); For females: contraception/family planning, Pre-Exposure Prophylaxis (PrEP) for HIV negative out-of-school females, and conditional cash transfer (CCT) for those in-school. The study evaluates coverage, uptake, intervention acceptability, and feasibility.

Results: In the first four of ten planned mobile health events, we enrolled 294 participants; 57% female, mean age 19 years. Eighty-four percent reported sexual activity; 15 years was the mean age of coitarche (range: 5-22yrs). Twenty of 30 HIV infections were new diagnoses (F=23; M=7). Thirty-percent were eligible for ART initiation and facilitated referrals were completed. All were enrolled in a longitudinal SMS-cohort. MMC uptake was low. Only 3 of 26 eligible males chose MMC. To date, approximately 46% of females participants may be eligible for CCT and 9% may be eligible for PrEP.

Conclusion:  Mobile events are an acceptable/feasible strategy for offering combination HIV prevention interventions to male and female youth. Mobile integrated HIV services can effectively identify previously undiagnosed HIV positive youth and link them to care.

Learning Areas:

Administer health education strategies, interventions and programs
Clinical medicine applied in public health
Implementation of health education strategies, interventions and programs
Public health or related nursing
Public health or related research

Learning Objectives:
Assess uptake of combination HIV prevention services among youth in rural western Kenya. Describe sexual and behavioral characteristics of high risk youth in sub-saharan Africa. Identify the challenges to identifying and enrolling females in a biomedical prevention intervention: Pre-Exposure Prophylaxis – Truvada for HIV prevention. Identify the challenges to administering a conditional cash transfer to in-school girls in rural sub-saharan Africa. Evaluate uptake of medical male circumcision in a mobile health setting. Compare gendered HIV prevalence and risk factors. Identify the proportion of youth newly diagnosed with HIV and their mean CD4 and Viral Load and understand the implications for care and treatment.

Keyword(s): HIV/AIDS, Youth

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a global health professional with more than 10 years of experience in research, analysis, project implementation, and impactful dissemination. I have served as a peace corps volunteer, worked in non-profits, university, state government, and currently work in federal government evaluating PEPFAR.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.