Increasing demand for Pre-Exposure prophylaxis (PrEP) among pregnant and breastfeeding women (PBFW) to prevent mother to child HIV transmission in 3 SAFE supported Provinces in Zambia

Title

Increasing demand for Pre-Exposure prophylaxis (PrEP) among pregnant and breastfeeding women (PBFW) to prevent mother to child HIV transmission in 3 SAFE supported Provinces in Zambia

Presenter

Tuhuma Tulli

Authors

T. Tulli * (1), L. Kalima (1), V. Peleka (1), R. Mvula (1), R. Makufele (1), B. Kafulubiti (2), S. Zulu (2), M. Chanda (2)

Institutions

(1) John Snow Inc, Monitoring and Evaluation, Lusaka, Zambia, (2) John Snow Inc, Technical, Lusaka, Zambia

BACKGROUND: The USAID SAFE program (SAFE) supports the HIV program of the Ministry of Health (MOH) in Zambia by providing clients who have been exposed to HIV with antiretroviral pre-exposure prophylaxis (PrEP) to prevent HIV infection. SAFE targets HIV negative pregnant and breast-feeding women (PBFW), victims of rape and gender based violence (GBV), sexually active adolescents and sex workers. Implementation of PrEP among PBFW has slowly been adopted in SAFE facilities and surrounding communities.
DESCRIPTION: SAFE recruited, trained and mentored health care workers to support MOH efforts to provide PrEP to PBFW and their infants. Campaigns and demand creation was done through radio programs, community outreach services, in churches, weekend clinics and engagement with traditional leaders on the promotion of PrEP among PBFW in the communities. PBFW were screened for HIV and those who tested negative and found eligible for PrEP were counselled and started on PrEP.
LESSONS LEARNED: Between October 2019 to December 2021, a total of 36,668 clients were initiated on PrEP and among them 6,111 (17%) were PBFW. The PrEP Initiation differed by Quarter (See figure 1). The Number of PBFW on PrEP was low from October 2019 to December 2020 as there were no demand creation and advocacy. The increase in PrEP initiation between January to December 2021 could be attributed to an increased campaign to initiate PrEP to PBFW with a peak in April to June 2021 with 2457 PBFW which is 34% contribution among all clients on PrEP. The drop in initiation in the month of October-December 2021 could be attributed to COVID 19 wave 4 which resulted in restrictions of community outreach services.

CONCLUSIONS: Creating awareness through radio health talks and general population advocacy increases awareness on the importance of PrEP and therefore, increases the number of PBFW accessing PrEP to prevent transmission of infection to their children.

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