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Wits RHI

The CATALYST Study

Infectious Diseases
Sexual and Reproductive Health

CATALYST: Catalysing Access to New HIV Prevention Products to Stop HIV

Rationale

The CATALYST implementation science study, under the MOSAIC Project, addresses the urgent need for innovative HIV prevention strategies for women in sub-Saharan Africa. Conducted in South Africa, Lesotho, Kenya, Zimbabwe, and Uganda, the study aims to accelerate the adoption and scale-up of new biomedical prevention tools, including pre-exposure prophylaxis (PrEP). By generating critical evidence, CATALYST supports informed decision-making to improve PrEP delivery and understand user preferences when offered a choice of products.

Study Overview

CATALYST evaluates an enhanced service delivery package that provides informed choices among three PrEP options: oral PrEP, PrEP ring, and CAB PrEP (injectable PrEP). This study builds on existing service delivery models and aligns with national guidelines to deliver PrEP choice at PEPFAR/USAID-supported health facilities.

The study comprises two main components:

  • A prospective cohort of PrEP users to assess uptake and usage patterns.
  • A mixed-methods process evaluation to understand the implementation process and its facilitators and barriers.

Objectives

  1. Implementation Analysis
    • Characterize the delivery of an enhanced service package for PrEP choice.
    • Assess facilitators and barriers across individual, provider, facility, community, and health system levels.
    • Evaluate health system feasibility, acceptability, and delivery costs.
  2. PrEP Use Patterns
    • Describe patterns of uptake, switching, and discontinuation across PrEP products.
    • Assess user acceptability and effectiveness of PrEP products.
  3. Clinical Outcomes
    • Monitor HIV infection rates and drug resistance among PrEP users.
    • Evaluate pregnancy and infant outcomes among participants.
    • Assess the sensitivity of HIV testing algorithms for CAB PrEP initiation.

Nested Studies

  1. Preventive Effective Use (PEU): Evaluate a PEU measure to understand PrEP usage patterns.
  2. HIV Testing Algorithms for CAB PrEP: Investigate alternative HIV testing strategies for CAB PrEP initiators.
  3. Community Acceptability: Examine the role of PrEP influencers (e.g., caregivers, partners) in supporting PrEP use.
  4. Costing Study: Analyze the costs of PrEP delivery (excluding South Africa).

Impact

CATALYST’s findings will refine PrEP delivery strategies, improve service quality, and advance global HIV prevention goals. Through capacity-building and quality improvement mechanisms, the study seeks to create sustainable, adaptable service models that prioritize user choice and community engagement.

Investigators

Global:

  • Kristine Torjesen, Project Director and Principal Investigator
  • Elizabeth Irungu, CATALYST Co-Investigator

South Africa:

  • Nicolette Naidoo, Country Lead and Principal Investigator
  • Prof Saiqa Mullick, Country Director and Co-Investigator
  • Dr Roisin Drysdale, National Study Lead Coordinator

Media Coverage

  1. FHI 360, 25 April 2024: FHI 360 and partners introduce injectable HIV prevention method as part of research study

Latest Update

April 2024

Click here for further details regarding the CATALYST Study.

For more details about CATALYST Study please email rhicomms@wrhi.ac.za

Project Brief

The CATALYST Study