Eswatini Ring Study: Increasing PrEP Options for Women

Conditions

HIV Prevention

Keywords

HIV prevention, PrEP, AGYW, PrEP Ring, Eswatini

Brief summary

The study will deliver PrEP choice between oral PrEP and the PrEP ring for women in PEPFAR/USAID public health service delivery sites, building on the existing PrEP service delivery models at each site and in accordance with national guidelines for PrEP service delivery in Eswatini. The overall goal of the study is to characterize and assess the feasibility, acceptability, uptake, patterns of use, and clinical outcomes of an enhanced service delivery package providing fully informed choice of oral PrEP and the PrEP ring among women, especially adolescent girls and young women, in Eswatini.

Detailed description

The study will deliver PrEP choice between oral PrEP and the PrEP ring for women in PEPFAR/USAID public health service delivery sites, building on the existing PrEP service delivery models at each site and in accordance with national guidelines for PrEP service delivery in Eswatini. The overall goal of the study is to characterize and assess the feasibility, acceptability, uptake, patterns of use, and clinical outcomes of an enhanced service delivery package providing fully informed choice of oral PrEP and the PrEP ring among women, especially adolescent girls and young women, in Eswatini. The two main study components include the following: 1. Prospective, observational cohort of eligible individuals interested in initiating PrEP or continuing PrEP with screening for entry at time of HIV testing and followed throughout the study period (up to 18 months). Data collection will involve quantitative methods and for a subset of participants, data will also be collected using qualitative means, namely in-depth interviews, and focus group discussions. 2. Mixed methods process evaluation that will document implementation of the enhanced service delivery package, assess ongoing perceptions of service delivery (i.e., acceptability and feasibility, barriers and facilitators) among providers and end users, and document other important implementation considerations including the integration of PrEP and family planning.

Anita Hettema, Siphesihle Shongwe, Haley Sisel, Mxolisi Khumalo, Ncediso Gama et al. (9 authors)

Journal of the International AIDS Society2025-07-012 citations

10.1002/jia2.26490

Interventions

None listed

Study design

Observational model

COHORT

Time perspective

PROSPECTIVE

Eligibility

Sex/Gender

FEMALE

Age

18 Years to No maximum

Healthy volunteers

Yes

Inclusion criteria

* HIV negative, 18 or older, not known to be pregnant or breastfeeding, and female at birth.

Design outcomes

Primary

Measure	Time frame	Description
Characterize implementation of the service delivery package for informed PrEP choice for women	18 months	Health system feasibility and delivery acceptance among users/providers

Secondary

Measure	Time frame	Description
Describe patterns of PrEP use in the context of informed PrEP choice	18 months	Overall and method-specific PrEP uptake; continuation/switching/discontinuation of PrEP products; product acceptability among users.

Other

Measure	Time frame	Description
Describe clinically relevant indicators among PrEP users, including rates of seroconversion and drug resistance among PEP users who acquire HIV following PrEP initiation.	18 months	Proportion and rates of HIV infection among participants; proportion and rates of HIV drug resistance (DR) mutations among PrEP users who acquire HIV.

Countries

Eswatini

Outcome results