Impact of community health worker intervention on PrEP knowledge and use in Rakai, Uganda: A mixed methods, implementation science evaluation.
Background: Effective models of support for HIV pre-exposure prophylaxis (PrEP) are needed for populations at elevated risk. In a hyperendemic Ugandan fishing community, PrEP counseling was provided through a situated Information, Motivation, and Behavioral Skills (sIMB)-based community health worke...
| Publicado en: | International Journal of STD & AIDS Vol. 33; no. 11; pp. 995 - 1005 |
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| Autores principales: | , , , , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Sage Publications Inc.
Oct2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=159608440&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 159608440 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09564624 8O9 jtl: International Journal of STD & AIDS issn: 09564624 maglogo: Y pubinfo: dt: Oct2022 vid: 33 iid: 11 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 159608440 158705333 159608440 NLM36006865 159608440 10.1177/09564624221121208 NLM36006865 159608440 ppf: 995 ppct: 10 formats: tig: atl: Impact of community health worker intervention on PrEP knowledge and use in Rakai, Uganda: A mixed methods, implementation science evaluation. aug: au: Edwards, Abagail J Pollard, Rose Kennedy, Caitlin E Mulamba, Jeremiah Mbabali, Ismail Anok, Aggrey Kong, Xiangrong Nakyanjo, Neema Ddaaki, William Nishimura, Holly Wawer, Maria Amico, K Rivet Hutton, Heidi E Nakigozi, Gertrude Chang, Larry W affil: Department of International Health, 25802 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA sug: subj: HIV Infections Drug Therapy Preventive Health Care Methods HIV Infections Prevention and Control Uganda Prospective Studies Community Health Workers Psychosocial Factors Funding Source ab: Background: Effective models of support for HIV pre-exposure prophylaxis (PrEP) are needed for populations at elevated risk. In a hyperendemic Ugandan fishing community, PrEP counseling was provided through a situated Information, Motivation, and Behavioral Skills (sIMB)-based community health worker (CHW) intervention. We evaluated the intervention using a mixed-methods, implementation science design.Methods: We surveyed all community members aged 15-49 through the Rakai Community Cohort Study. We used multivariable logistic regressions with generalized estimating equations to estimate the intervention's effect on PrEP knowledge and utilization. To understand intervention experiences and mechanisms, we conducted 74 qualitative interviews with 5 informant types (clients, CHWs, program staff, community leaders, health clinic staff) and analyzed data using an iterative, deductive approach. A mobile phone application provided intervention process implementation data.Results: Individuals self-reporting receipt of the CHW intervention showed significantly higher PrEP knowledge (N = 1848, PRR: 1.10, 95% CI: 1.06-1.14, p = <.0001), PrEP ever use (N = 1176, PRR: 1.77, 95% CI: 1.33-2.36, p = <.0001), and PrEP current use (N = 1176, PRR: 1.86, 95% CI: 1.22-2.82, p = 0.0039) compared to those who did not. Qualitative findings attributed positive PrEP outcomes to CHW counseling and effective use of motivational interviewing skills by CHWs. Salient themes across the RE-AIM framework included support for the CHW intervention and PrEP across clients, community, and implementers. Mobile application data demonstrated consistent delivery of the PrEP module throughout implementation.Conclusions: CHWs improved PrEP knowledge and use among clients in an HIV hyperendemic fishing community. Mixed-methods, implementation science evaluations can inform adaptation of similar PrEP implementation strategies. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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