iPrEP‐STI

Integrating HIV Pre-exposure Prophylaxis and diagnostic STI care: An individualised public health approach (iPrEP-STI)

Summary

South Africa has some of the highest rates of sexually transmitted infections (STIs) and HIV globally. New STIs infections are increasing among South African adolescents where comprehensive and integrated quality of health services are limited. South African guidelines for treating STIs are not based on the diagnosis of the actual pathogen that causes the STI but uses the syndromic approach which means that people may get antibiotics that they do not need. Further, the majority of people with an STI, especially women, are asymptomatic, hence do not get the treatment that they need. Additionally those on PrEP showed a higher incidence of STIs; 21% of PrEP users had chlamydia compared to the global average of 3%. Hence, integrating diagnostic STI care and PrEP provides a unique opportunity to reduce STI

incidence. The SA National Strategic Plan (NSP) for HIV, TB and STIs (2017-2022), highlights the need to address the high burden of STIs, detection and management of asymptomatic STIs with increased laboratory support and use of Point-of-Care (POC) testing for common STIs. Hence the aim of this study is to engage policy makers, healthcare providers and patients in discrete choice experiments to establish preferences for diagnosis and treatment of STIs and assess the feasibility of integrating these within the South African health-system.

Primary Objectives

• Conduct a literature review on antimicrobial resistance and STIs in sub-Saharan Africa
• Formative research on policy maker, healthcare providers and client preferences on different types of STI sample collection, diagnosis, receipt of results, treatment and partner notification using discrete choice experiments (DCE)
• Determine the three most preferred permutations amongst the themes of STI sample collection, diagnosis, receipt of results, treatment and partner notification based on data derived from the DCEs
• Determine feasibility of implementing the three most preferred permutations amongst the themes of STI sample collection, diagnosis, receipt of results, treatment and partner notification within the South African health system

Study Population

• Clients at facilities receiving PrEP,
• as well as healthcare providers and key stakeholders (policy makers, key informants)

Investigators

• Dr Saiqa Mullick,
• Dr Collins Iwujii,
• Diantha Pillay

Sponsors/Donors

• NIHR (UK)

Latest Update:

15 February 2021

For more about iPrEP-STI please email rhicomms@wrhi.ac.za