Use of Tracker to enhance Oral pre-exposure prophylaxis adherence among Adolescent Girls and Young Women in DREAMS Clubs – Zomba EMPOWER Pakachere experience
The Abstract was presented at the National Symposium for Youth and AGYW at BICC, Lilongwe on 31 August 2022.
Authors: Tadala Simika1, Andrew Chumachienda1, Kumbukani Chawinga1, Allan Kalande1, Oramah Bokosi1, Bright Mkandawire1, Efred Mfitilodze1, Ephraim Kwachera, Maria Mkandawire2, Nennie Lungu2, Patrick Gwaza2, Pius Mtike2, Fatsani Gadama2, Mathew Kakhulungo2, Yona Nyondo2
1 Pakachere, Malawi EMPOWER
2 FHI360, Malawi EMPOWER
Introduction
Adolescent girls and young women (AGYW, aged 15-24 years) bear a disproportionate burden of HIV infection. Fortunately, oral pre-exposure prophylaxis (PREP) is a self-initiated option to reduce AGYW-HIV risk as such AGYW who wish to use oral PREP understand their risk and want to protect themselves from HIV acquisition. Zomba EMPOWER-Pakachere creates demand through provision of PREP information, ensures active referral of AGYW at risk of acquiring HIV. This abstract highlights the strategies which Zomba EMPOWER-Pakachere use to enhance oral PREP among AGYW in DREAMS clubs who are at risk of HIV infections.
Methodology
Zomba EMPOWER-Pakachere service providers reach out to Adolescent Girls and Young Women (AGYW) in DREAMS clubs in six facility catchment areas of Likangala, Mayaka, Matiya, Magomero, Thondwe and Namikango. To create demand and enhance Prep uptake among AGYW, EMPOWER Pakachere service providers provides PREP information before service provision and those that are eligible for PREP are actively referred to nearest health facility where PREP services are offered. In addition, Zomba EMPOWER-Pakachere also use PrEP tracker which acts as a reminder on the next date of appointment as well as outcomes for PREP AGYWs. Good collaboration between EMPOWER and treatment partners (EGPAF and MOH) as well as use of cadres (YCBDAs, PREP champions, DREAMS ambassadors and Ana Patsogolo DREAMS facilitators) who assist in provision of PREP information, mobilization, and active referral of AGYW who eligible and following up all those who are due for a refill according to the tracker Furthermore, Zomba EMPOWER-Pakachere provides transport to referred PREP AGYW from hard to reach to health facility to access PREP services. To understand the impact of these strategies, Zomba EMPOWER-Pakachere analyzed data from April 2021 to June,2022.
Results
From the period April 2021 to June,2022, the total number of AGYW PrEP continuation increased from 47 in FY2021 Q3 to 112 in FY2022 Q3 representing 297% achievement of quarterly target of 38. The increase from FY2021 Q3 to FY2022 Q3 demonstrated improvement on PrEP continuity with the use of PrEP tracker thereby reducing risk of HIV infections among AGYW in DREAMS Clubs.
Conclusion
Use of PrEP tracker for tracking AGYW on PrEP is a key strategy to enhance oral pre-exposure prophylaxis among adolescent girls and young women in DREAMS clubs.
Recommendations
Community based PrEP services can enhance uptake of PrEP among AGYW as they will be accessing PrEP services right at the community rather than walking long distances to access PrEP at the facility. Tracking of PrEP-AGYW can improve adherence as the AGYW cannot miss date of appointment thereby reducing risk to HIV infections among adolescent girls and young women in DREAMS clubs. Collaboration with community partners, clinical partners and community cadres will also enhance PrEP uptake among AGYW.
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