PALESA

A Pilot Randomized Controlled Trial to Assess a Model of Decentralised STI-Self Testing and Risk Self-Assessment Among Adolescent Girls and Young Women in South Africa to Trigger PrEP Re-start (PALESA).

Rationale

In South Africa (SA), adolescent girls and young women (AGYW) face significant rates of new HIV infections. HIV pre-exposure prophylaxis (PrEP) can be highly effective in reducing HIV incidence with consistent adherence to dosing schedules. However, AGYW under 25 often struggle with daily PrEP adherence and program continuity. Reasons for non-use or discontinuation vary, including issues related to the product itself, individual user challenges, and social network dynamics. One common reason reported is a low perceived risk of acquiring HIV. Thus, it’s crucial to empower AGYW to recognize periods of heightened HIV risk and promote better PrEP utilization during these times.

In addition to HIV, curable bacterial sexually transmitted infections (STIs) increase the risk of HIV transmission, and SA has notable prevalence rates of Chlamydia trachomatis (CT), Neisseria gonorrhea (NG), and Trichomonas vaginalis (TV) among young women aged 15–24. These STIs can severely impact sexual, reproductive, and general health, leading to social harms. Effective identification and management of STIs are therefore imperative. Self-testing has revolutionized HIV testing by reducing stigma and offering discreet testing in less private settings. Extending self-testing to STIs seems a logical progression, although currently unavailable. Nonetheless, recent studies demonstrate high acceptability and feasibility of self-collected swabs for NG, CT, and TV testing, suggesting potential for AGYW to use commercially available rapid test kits for self-testing of STIs.

Investigators

• Prof Thesla Palanee-Phillips (Principal Investigator)
• Krishnaveni Reddy (Co-Principal Investigator)
• Prof. Renee Heffron (Co-Principal Investigator)

Latest Update

March 2024

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

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