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dc.contributor.authorWechsberg, W.M.
dc.contributor.authorBrowne, F.A.
dc.contributor.authorNdirangu, J.
dc.contributor.authorBonner, C.P.
dc.contributor.authorMinnis, A.M.
dc.contributor.authorNyblade, L.
dc.contributor.authorSpeizer, I.S.
dc.contributor.authorHoward, B.N.
dc.contributor.authorMyers-Franchi, Bronwyn
dc.contributor.authorAhmed, K.
dc.identifier.citationWechsberg, W.M. and Browne, F.A. and Ndirangu, J. and Bonner, C.P. and Minnis, A.M. and Nyblade, L. and Speizer, I.S. et al. 2020. The PrEPARE Pretoria Project: protocol for a cluster-randomized factorial-design trial to prevent HIV with PrEP among adolescent girls and young women in Tshwane, South Africa. BMC Public Health. 20 (1): Article No. 1403.

Background: Despite increased prevention efforts, HIV remains the leading cause of death among adolescent girls and young women in South Africa. Although research indicates important determinants of HIV acquisition at the individual and interpersonal levels, structural-level stigma and discrimination continue to be critical barriers to reaching and retaining this key population for HIV prevention and sexual and reproductive health services. Innovative and multilevel interventions are needed that can address the intersectional structural and gender issues that young women face, including stigma, alcohol and drug use, gender-based violence, and other risk factors when seeking health services. Oral pre-exposure prophylaxis (PrEP) taken daily has been found to be an effective biomedical HIV prevention tool. Testing a comprehensive gender-focused biobehavioral HIV prevention intervention that is inclusive of social ecological determinants, such as stigma and discrimination reduction in clinics, is critical for reducing HIV among adolescent girls and young women. Methods: This project involves both a Community Collaborative Board and a Youth Advisory Board in helping to adapt the Young Women's Health CoOp intervention and the Health Policy Project (HPP) Stigma and Discrimination (S&D) reduction training curriculum to the setting and population. This study uses a two-by-two factorial design with stratified randomization of 12 clinics, each with distinct catchment areas. The Young Women's Health CoOp addresses substance use, sexual risk, violence prevention and sexual negotiation, condom demonstration, and problem solving with the following additions: knowledge of PrEP, the importance of PrEP adherence, and sexual and reproductive health. Adolescent girls and young women will be assessed with behavioral and biological measures at baseline, 3-, 6- and 9-month follow-up. The S&D reduction training is provided for all staff in the clinics randomized to this condition. Clinic staff will be surveyed at baseline, 4- and 8-month follow-up. We will recruit 900 AGYW from communities in the 12 clinic catchment areas. Discussion: The study findings, if efficacious across the outcomes, will be incorporated into the gender-focused HIV prevention intervention toolkit and disseminated to inform multilevel prevention approaches. Trial registration: Identifier: NCT04048551 (Recruiting). Registered: August 7, 2019 (Retrospectively registered).

dc.subjectScience & Technology
dc.subjectLife Sciences & Biomedicine
dc.subjectPublic, Environmental & Occupational Health
dc.subjectSexual and reproductive health (SRH)
dc.subjectHealth Policy Project Stigma and Discrimination-reduction training (HPP S&D)
dc.subjectClinic staff
dc.subjectYoung Women's Health CoOp (YWHC)
dc.subjectAlcohol and drug use
dc.subjectGender-based violence
dc.subjectHEALTH COOP
dc.subjectSEX WORKERS
dc.subjectUSE DRUGS
dc.titleThe PrEPARE Pretoria Project: protocol for a cluster-randomized factorial-design trial to prevent HIV with PrEP among adolescent girls and young women in Tshwane, South Africa
dc.typeJournal Article
dcterms.source.titleBMC Public Health

© The Author(s). 2020 Published in BMC Public Health. This article is published under the Open Access publishing model and distributed under the terms of the Creative Commons Attribution License Please refer to the licence to obtain terms for any further reuse or distribution of this work.

curtin.departmentEnAble Institute
curtin.accessStatusOpen access
curtin.facultyFaculty of Health Sciences
curtin.contributor.orcidMyers-Franchi, Bronwyn [0000-0003-0235-6716]
curtin.identifier.article-numberARTN 1403
curtin.contributor.scopusauthoridMyers-Franchi, Bronwyn [7202684194]

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