Roman Shrestha

Promoting tailored approaches to HIV service delivery to meet the needs of key populations can improve HIV prevention efforts. In this session, the panelists explored the implementation of innovative HIV service delivery approaches in at-risk groups in various geographical settings (Kenya, Thailand, South Africa, and Ukraine).

Lauren Gomez presented safety outcomes beyond infancy (24-30 months) following maternal PrEP in Kenya. The findings supported the prior result that no differences in growth or neurodevelopmental outcomes were found between children with and without prenatal PrEP exposure, thus indicating the safety of prenatal PrEP use. Peevara Srimanus shared the impact of gain-framed PrEP counseling on PrEP uptake among transgender women at a trans-friendly clinic in Bangkok, Thailand. Replacing traditional risk-based counseling with empowering messages focusing on health (gain-framed) was found to improve PrEP uptake overall, particularly among TGW without self-perceived risk. Jennifer Velloza discussed the efficacy of the mHealth-based (SMS vs. WhatsApp) stepped PrEP adherence support intervention on PrEP adherence among young women in South Africa. Although PrEP adherence was higher than in comparable cohorts, the data demonstrated that these two mHealth-based individual tailored adherence approaches similarly impact PrEP adherence. Lastly, Svitlana Leontieva showed the use of a peer-driven community outreach model that leveraged social network testing (SNT) to extend the reach of HIV testing services to networks of PWID in Ukraine. This model significantly increased HIV testing and subsequent linkage to HIV (e.g., PrEP, ART) and other support services (e.g., MOUD).

Each key population has its own demands and needs. In the era of constrained resources, it is important that we identify intervention components that are most effective and tailor the HIV prevention package that accounts for the unique and challenging circumstances that these at-risk groups face.