# Integrating PrEP delivery in family planning clinics in Kenya

> **NIH NIH R01** · UNIVERSITY OF WASHINGTON · 2021 · $594,356

## Abstract

ABSTRACT
Women in HIV high burden settings are a priority population for HIV prevention, because they carry
disproportionately high fraction of new HIV infections. A recent large clinical study (ECHO Study) in four African
countries found that incident HIV infections were unacceptably high among women desiring contraception– an
average of 3.8%. These results have rightly spurred discussions about the need to strengthen integration of HIV
prevention and sexual reproductive health services. Oral pre-exposure prophylaxis (PrEP) is an attractive user-
controlled HIV prevention strategy, given its high effectiveness and safety. Integrating HIV prevention services,
including PrEP provision into care settings that women trust and access routinely may offer an efficient platform
to reach at-risk women for HIV prevention. In a recent pilot study, we demonstrated that it was feasible to
integrate PrEP provision in FP clinics with program-dedicated staff. However, that approach also highlighted the
need for delivery models that integrate efficiently with existing staff for sustainability. With a multidisciplinary
team and drawing from lessons from the pilot work, we propose to catalyze scale up PrEP provision for at-risk
women accessing FP clinics in Kisumu, Kenya – a region with an HIV prevalence of up to 28% among young
women. We will aim for a sustainable, institutionalized, and cost- and time-efficient PrEP delivery in FP clinics.
We hypothesize that FP clinics will provide woman-centered ‘one-stop’ location for PrEP and FP services that
could address barriers women face to access HIV prevention services, including lack of time, cost, and stigma
of visiting a facility solely for HIV prevention. We will conduct a step-wedged cluster-randomized trial to test a
multifaceted implementation strategy in 12 FP clinics (n=3600 women) with the following Aims: In Aim 1, we will
deliver PrEP in public health FP clinics in staged fashion, implementing and optimizing HIV prevention service
provision with existing FP clinic staffing. We will rigorously evaluate program reach, effectiveness, adoption,
implementation, maintenance, and impact using the RE-AIM framework. The multifaceted implementation
strategy to integrate PrEP in FP clinics will include: 1) provider training; 2) promotion of HIV testing, partner HIV
testing, screening for HIV and STIs risk and offer of PrEP; 3) ongoing technical assistance; 4) Audit and feedback
to optimize delivery; 5) work-flow mapping; and 6) streamlined data and PrEP supply systems. In Aim 2, guided
by the Organizational Readiness for Implementing Change and the Consolidated Framework for Implementation
Science Research, we will assess readiness to implement, fidelity, impact on current services, facilitators, and
barriers to integration PrEP provision in FP clinic context. In Aim 3, we will assess programmatic cost, budget
impact, and affordability of integrating PrEP delivery in FP clinics in Kenya. Costs will be estimated over a...

## Key facts

- **NIH application ID:** 10152687
- **Project number:** 5R01MH123267-02
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Kenneth Kiggundu Mugwanya
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $594,356
- **Award type:** 5
- **Project period:** 2020-05-01 → 2025-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10152687

## Citation

> US National Institutes of Health, RePORTER application 10152687, Integrating PrEP delivery in family planning clinics in Kenya (5R01MH123267-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10152687. Licensed CC0.

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