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Lunani LL, Gafos M, Indravudh P, Korir J, Koki E, Malogo R, et al. Young women’s use of existing contraceptive and HIV prevention products and preferences for future multi-purpose prevention technologies (MPTs) in Kampala and Nairobi: finding from a respondent driven sampling (RDS) survey. [Poster presentation] HIV R4P 2024. October 2024.

Adolescent girls and young women (AGYW) in Sub-Saharan Africa are faced with multiple sexual and reproductive health (SRH) challenges, including the need for family planning (FP), and protection from HIV and other sexually transmitted infections (STIs). Current SRH products typically offer protection against a single indication, not meeting women’s multiple SRH needs. Recognizing this gap, we aimed to assess preferences for future multipurpose prevention technologies (MPTs) among AGYW in Kampala and Nairobi. The study revealed a strong preference among AGYW for MPTs that provide protection against HIV and pregnancy, are delivered orally or by injection, that offer medium to longer term coverage and are available at fixed clinic settings. While recognizing the limitations of hypothetical research, understanding AGYW’s preferences is important  for designing products that are not only effective but also acceptable to the women who need them most.

PUBLICATIONS

PANEL: Designing products that meet community aspirations – Understanding end-user preferences for emerging HIV biomedical prevention technologies across East Africa and India. IAS 2023, Sydney. July 2023.

 

UPTAKE presented in a satellite panel at IAS 2023 in Sydney on Sunday 23 July 2023. The panel explored designing products that meet community aspirations by understanding end-user preferences for emerging HIV biomedical prevention technologies across East Africa and India. In addition to the panel discussion, UPTAKE study investigators Yvonne Wangũi Machira, IAVI, and Francis Meyo, Busara, presented findings from stages 1 and 2 respectively.

Watch the video here.

Wangũi Machira Y, Kuteesa M, Gao L, Muthike W, Anzala O, Omosa-Manyonyi G, et al. Behavioural Determinants of Uptake of Long-Acting HIV and Multi-Purpose Prevention Technologies among Adolescent Girls and Young Women (AGYW) and Female Sex Workers (FSW) in Kenya and Uganda. 10th EDCTP Forum. October 2021. 

AGYW and FSW in sub-Saharan Africa are vulnerable and susceptible to HIV, sexually transmitted infections, and unplanned pregnancies. End-user research that considers their needs, preferences and behaviour is critical to inform design, development, access to and uptake of long-acting HIV (LA-HIV) and multi-purpose prevention technologies (MPTs). Understanding health system and programmatic perspectives from healthcare providers (HCPs) and policymakers (PMs) is also critical towards product introduction.

Lunani LL, Namukwaya S, Lipesa S, Kombo B, Omodi D, Shikuku J, et al. Perspectives and Preferences for Multi-Purpose Prevention Technologies (MPTs) to Address Sexual and Reproductive Health (SRH) Needs Among Adolescent Girls and Young women (AGYW) in Nairobi and Kampala. AIDS 2022, Montreal. July 2022. 

AGYW in Sub Saharan Africa are disproportionately affected by high rates of HIV, sexually transmitted infections (STIs) and unintended pregnancies. To inform development of MPTs and delivery of SRH services, an innovative behavioural science research project (UPTAKE) seeks to determine factors that facilitate future acceptability and uptake of long-acting (LA) technologies to prevent HIV and unintended pregnancy among AGYW in Nairobi, Kenya and Kampala, Uganda.

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Katumba KR, Haumba M, Gafos M, Mayanja Y, Gomez G, Ruzagira E, et al. Understanding the Structural Factors that Influence Female Sex Work in Kampala, Uganda. STI & HIV 2023 World Congress, Chicago, USA. July 2023.

Female sex workers (FSW) globally have higher risk of HIV infection than the general population. Pooled odds of HIV infection of 13.5 (10.0–18.1) for FSW in LMICs compared to general population. HIV transmission affected by interaction of Structural * Social * Interpersonal * Individual factors. Structural factors can be economic, social, policy,  and organisational, or barriers or facilitators for uptake of HIV prevention services. Our study documented women that advertise and meet clients using online platforms. To a larger extent, women face similar structural factors regardless of where they get clients however women meeting clients online have particular challenges, including cybersecurity , blackmail, and challenges in connecting with researchers and HIV prevention efforts. Interventions against HIV transmission or acquisition should consider the differences in structural factors, challenges and risks in order to reach all women selling sex in Kampala.
 

Namukwaya S, Katumba K, Kayesu I, Nabalwanyi Z, Naluwooza R, Mayanja Y, et al. Female sex workers’ preferences for Multi-Purpose Technologies (MPTs) to prevent HIV, other Sexually Transmitted Infections (STIs) and unintended pregnancies in Kampala, Uganda. AIDS 2022, Montreal. July 2022. 

 

To inform the development of MPTs, a formative study to explore FSWs preferences for future HIV prevention MPTs was conducted as part of a larger innovative behavioural science research project (UPTAKE) that is seeking to determine factors that facilitate future uptake of long-acting technologies to prevent HIV and unintended pregnancy among FSWs in Nairobi, Kenya and Kampala, Uganda.

Wangũi Machira Y, Gao L, Koki E, Korir J, Shari S, Anzala O, et al. Behavioural Predictors of Uptake of HIV and Pregnancy Prevention Products among Adolescent Girls and Young Women and Female Sex Workers in Kenya and Uganda. 11th EDCTP Forum, Paris. November 2023. 

 

UPTAKE is a programme that seeks to accelerate access and facilitate adherence to effective and innovative long-acting technologies to prevent HIV and unintended pregnancy among Adolescent Girls and Young Women (AGYW) and Female Sex Workers (FSW) through behavioural science in Kenya and Uganda. We identified behavioural characteristics which predict the use of HIV and pregnancy prevention products and measured the strength of preferences.

Katumba KR, Haumba M, Mayanja Y, Wangũi Machira Y, Gafos M, Quaife M, et al. Understanding the contexts in which female sex workers sell sex in Kampala, Uganda: a qualitative study. BMC Women's Health 24, 371 (2024). doi/10.1186/s12905-024-03216-7

Structural, interpersonal and individual level factors can present barriers for HIV prevention behaviour among people at high risk of HIV acquisition, including women who sell sex. This study documents the contexts in which women selling sex in Kampala meet and provide services to their clients. The study team collected qualitative data using semi-structured interviews with 10 women who met clients in venues and outdoor locations and 10 other women who met clients onlineTo reduce risk of HIV acquisition among women who sell sex, researchers and implementers should consider the differences in the contexts of where women sell sex, challenges, and risks to design innovative interventions and programs that reach and include all women.

UPTAKE is proud to share the following article first-authored by Ivy Kayesu, MSc candidate at MRC/UVRI & LSHTM Uganda Research Unit and one of four UPTAKE scholars. This paper was made possible through IAVI's ADVANCE program, a 10-year cooperative agreement with the U.S. Agency for International Development (USAID), through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR).

 

Kayesu I, Mayanja Y, Nakirijja C, Machira Y, Price M, Seeley J, Siu G. Uptake of and adherence to oral pre-exposure prophylaxis among adolescent girls and young women at high risk of HIV-infection in Kampala, Uganda: A qualitative study of experiences, facilitators and barriers. BMC Women's Health. November 2022. ​

There is limited information on factors that influence oral pre-exposure prophylaxis (PrEP) uptake and adherence among adolescent girls and young women (AGYW). We conducted a qualitative methods study to explore experiences, facilitators and barriers of PrEP uptake and adherence to PrEP among AGYW at risk of Human Immunodeficiency Virus (HIV) infection in Kampala, Uganda.

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