# Delivery of integrated PrEP and ART for HIV prevention for couples in Kenya

> **NIH NIH R01** · UNIVERSITY OF WASHINGTON · 2020 · $147,098

## Abstract

ABSTRACT
Maximizing access is one of the key challenges for optimizing the public health impact of pre-exposure
prophylaxis (PrEP) for HIV prevention. The coronavirus disease 2019 (COVID-19) epidemic has overwhelmed
health systems globally. In Africa, PrEP has been added to an already-burdened health infrastructure, and the
overlay of COVID-19 threatens derail the tremendous progress made with HIV treatment and prevention,
including provision of PrEP. Since 2017, in collaboration with the Kenyan Ministry of Health, we have been
conducting a large step-wedge randomized roll-out of PrEP delivery in 24 high-volume, PEPFAR-supported,
public HIV care facilities, using detailed data abstraction from clinic records and implementation science methods
(including the RE-AIM framework), plus training and technical assistance in another ~70 clinics outside of the
randomized trial (together, the work is called the Partners Scale-Up Project). We have found high enthusiasm
among providers and clients, with good uptake, continuation, and adherence for PrEP and clinic-initiated
adaptions that may PrEP delivery more efficient. During the current COVID-19 emergency, we have continued
remote provision of technical assistance to monitor implementation progress and cross-pollinate best practices
across clinics. We are hearing that health providers feel ill-prepared to manage or screen for COVID-19 but
nevertheless remain committed to serving clients. Clinics have rapidly accelerated adaptations to continue
services provision, including dispensing longer PrEP refills, quickly initiating one-stop provision of PrEP services
(to minimize staff-client contact), and shifting PrEP services to HIV testing centers and potentially to community-
based delivery. Incredibly, PrEP initiations/refills are continuing at a rate similar to 2019. Thus, we hypothesize
that despite the alarming implications for individuals and health systems of the COVID-19 emergency, there is
both resilience of public health clinic staff and opportunity for health systems to adapt and innovate efficient
strategies for provision of critical services. In this administrative supplement, we propose to add a novel aim (Aim
5) to explore the impact of COVID-19 on PrEP services, specifically clinic adaptation and staff resilience. We
propose to document and accelerate rapid adaptations in PrEP services across the ~100 clinics across Kenya
in our network, using our technical assistance model to cross-pollinate best practices that mitigate COVID-19
impacts. Qualitative interviews will explore provider distress and identify key components of resilience and PrEP
service adaptation. The work is fully within the scope of our ongoing project, which has explicit goals of
understanding barriers and facilitating innovations for PrEP delivery for providers and health systems. Given our
robust technical assistance network and data collection systems (including phone/video interviews), this work
can begin immediately and wi...

## Key facts

- **NIH application ID:** 10158924
- **Project number:** 3R01MH095507-10S1
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Jared Baeten
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $147,098
- **Award type:** 3
- **Project period:** 2011-08-10 → 2022-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10158924

## Citation

> US National Institutes of Health, RePORTER application 10158924, Delivery of integrated PrEP and ART for HIV prevention for couples in Kenya (3R01MH095507-10S1). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10158924. Licensed CC0.

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