Moving from biomedical HIV prevention to 'V ineka that, that, that!': early insights from implementing 'V' in Zimbabwe

Title

Moving from biomedical HIV prevention to 'V ineka that, that, that!': early insights from implementing 'V' in Zimbabwe

Presenter

Thenjiwe Sisimayi

Authors

T. Sisimayi * (1), D. Nhamo (2), G. Chapwanya (2), K. Chatora (3), T. Mawoyo (3), E.L. Harris (4), K.D. Shelley (5)

Institutions

(1) Independent Consultant, Harare, Zimbabwe, (2) Pangaea Zimbabwe AIDS Trust (PZAT), Harare, Zimbabwe, (3) Population Services International (PSI), Harare, Zimbabwe, (4) United States Agency for International Development (USAID), Office of HIV/AIDS, Washington DC, United States, (5) PATH, Health Systems, Seattle, United States

BACKGROUND: Adolescent Girls and Young Women (AGYW) remain disproportionately affected by HIV in Zimbabwe where new infections are more than double those among young men. HIV prevention options are available, including oral pre'exposure prophylaxis (PrEP), however AGYW face significant barriers to PrEP uptake and continuation. In 2021, PSI and PZAT launched 'V' in four districts with the aim of reframing PrEP as an empowering self-care product that young women desire. 'V' consists of fashionable branding (including 'starter kit''pill case, FAQ guide, makeup bag, reminder sticker), service integration, and peer education/support through online fora. Our objective was to characterize early learnings to inform implementation and scale up.
METHODS: Observations and interviews explored 'V''s acceptability and relevance to target users, and feasibility of integrating 'V' into existing service delivery. In-depth interviews (n=46) were conducted with healthcare workers, Brand Ambassadors (PrEP champions), and young women (18-24) sampled from four sites. Interview data was analyzed thematically using the framework method for qualitative data management and analysis. Project budgets and invoices were reviewed to compile unit cost data and procurement quantities for all 'V' materials.
RESULTS: Interviews indicated 'V' is highly acceptable due to attractive branding coupled with factual and thought provoking messaging, establishing 'a girl code' for talking about PrEP, and addressing a gap in communications materials. One young woman described 'V' as 'V ineka that, that, that!' which translates to 'in a class of its own!' 'V' was also feasible and efficient to integrate into routine service provision, including with adolescent health services and through outreach events. Interest in "V" beyond AGYW was substantial. Minor adaptations to 'V' materials (color, size) were identified to better suit the context and to address possible unwanted disclosure issues.
CONCLUSIONS: Early learnings indicate V is an acceptable and feasible innovation to help support demand creation for PrEP and continuation among AGYW in a variety of settings. National scale up discussions are ongoing pending impact analyses and sustainability considerations. Plans for scale up could explore savings through higher volume procurement and by adopting a customized lighter package of the most essential 'V' materials, while still retaining "V"''s core approach.

Download the e-Poster (PDF)