Triple P: Private Pharmacy engagement to prevent HIV in adolescent girls and young women and at-risk young men

Why Triple P?

Despite being at greatest risk to HIV infection in Zimbabwe, adolescents girls and young women and at-risk young people have lowest uptake of HIV prevention, testing and treatment services. Work by OPHID (see Zvatinoda (what we want)) and others has shown that this low uptake is due to fear of judgement and stigmatisation by health workers in public health facilities.

Increasing evidence demonstrates that many groups that face stigma and discrimination for accessing HIV and other essential sexual and reproductive health services seek out services in private pharmacies and health providers
The program, which started in 2019-2024 Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) supported NIH R01 and is continuing through to 2029 (NIH R37) involves a multi-country collaboration of investigators in United States, South Africa, Côte d’Ivoire, and Zimbabwe using microsimulation models to examine emerging care and treatment approaches across the spectrum of pediatric HIV care.

Acceptable, scalable and sustainable models to engage private pharmacies to enhance HIV prevention for at-risk groups are required.

Triple P: Predict Risk; Pre-Exposure and Post-exposure HIV Prevention

In 2023, with support from USAID, OPHID began the Triple P project which seeks to work with private sector health providers and pharmacies to increase access to established private sector networks to co-design and implement an innovative integrated ‘Triple P’ private sector HIV prevention model to address:

1)Predictors of HIV risk (STI screening  and treatment, HPV screening & vaccination, HTS, unmet FP needs/HIV exposure), 2) HIV Prevention method needs (PrEP, condoms other emerging prevention technologies), and 3) Post-exposure prevention services to increase the uptake of comprehensive person-centred HIV prevention services among male and female SWs, AGYW, and at-risk young men who access services at private sector institutions.

The goal of Triple P is to co-design and document evidence for a scalable private sector HIV/SRH prevention service delivery model for most-at-risk young people and key populations through private providers (pharmacies and physicians).

Triple P activities and outputs

OPHID will employ human centred design approaches to codesign the Triple P strategy together with local (Bulawayo), national private provider professional bodies and priority populations to improve acceptability and feasibility of the resulting model to increase access to HIV prevention screening, referrals and HIV and sexual and reproductive health (SRH) biomedical prevention and treatment commodities among at-risk AGYW, men and key populations.

We will implement a Triple P learning phase in 10 private pharmacies and with 10 private physicians in Bulawayo, building on existing capacity and services.

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By 2025, the Triple P project aims to:

  1. Increase coordination and participation of the private sector in the HIV prevention response for at-risk AGYW, men and KPs in Zimbabwe.
  2. Improve capacity of private sector entities to deliver effective HIV prevention interventions through training and development of digital information sharing platforms.
  3. Increase access to and uptake of comprehensive and integrated Triple P HIV prevention services in the private sector by among AGYW and at-risk men and KPs
  4. Develop an innovative private sector package of ‘triple P’ HIV prevention services that is evidence-based, costed, and scalable, together with a plan for scale (Y3-5).

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