Title

Demand creation strategies to increase acceptance of HIV pre-exposure prophylaxis among pregnant and breastfeeding women (PBFW) as part of the eMTCT strategy in Mazowe District, Zimbabwe

Presenter

Brighet Chiururwi

Authors

B. Chiururwi¹, P. Moyo¹, J. Murungu¹, S. Nyakuwa¹, C. Hera¹, I. Mahaka¹, P. Manyanga², E. Chidovi³, T. Sola⁴, G. Gonese², B. Makunike², T. Mharadze⁵, R. Malaba⁵, K. Thompson⁶, S. Wiktor⁶

Institutions

¹Pangaea Zimbabwe AIDS Trust, Harare, Zimbabwe, ²Zimbabwe Technical Assistance, Training & Education Centre for Health (Zim-TTECH), Harare, Zimbabwe, ³Zimbabwe Technical Assistance, Training & Education Centre for Health (Zim-TTECH), Programs, Harare, Zimbabwe, ⁴Ministry of Health and Child Care (MOHCC), Harare, Zimbabwe, ⁵Centers for Disease Control and Prevention (CDC) Zimbabwe, Harare, Zimbabwe, ⁶International Training and Education Center for Health (I-TECH), University of Washington, Seattle, United States

BACKGROUND: Pre-exposure prophylaxis (PrEP) is effective in reducing risk of HIV acquisition among all populations, including pregnant and breast-feeding women (PBFW) as part of the national elimination of mother-to-child transmission (eMTCT) strategy in Zimbabwe. However, PrEP uptake has been low among PBFW due to limited awareness. Pangaea Zimbabwe AIDS Trust (PZAT), in collaboration with MOHCC and partners initiated targeted demand creation activities to ensure PBFW are reached with PrEP services across public health facilities in Mazowe district.
DESCRIPTION: From July to October 2022, 50 Health workers (HCWs) from 29 supported facilities including nurses, primary councilors, health promotion officers were trained using the standard MOHCC training package. During the same period, 35 existing PrEP Champions (PCs) were oriented on demand creation and PrEP for PBFW. PCs are women trained to raise awareness, mobilize, and advocate for PrEP uptake through peer-peer models. The HCWs and PCs delivered targeted demand creation activities including eMTCT and PrEP Information Sessions (PISs) directed at PBFW at Family and Health Care departments. Facilities held 1-2 sessions per day, depending on client volume. Safety and benefits of using PrEP during pregnancy and breast-feeding were emphasized. PBFW Interested and eligible for PrEP were linked to services.
LESSONS LEARNED: Targeted demand creation activities through multiple platforms at facility level increased PrEP uptake among PBFW. From July-October 2022, 220 PISs reached 578 PBFW. During the same period, 210 pregnant and 224 breast-feeding women were initiated on PrEP translating to 73% uptake. However, facility-based PISs are limited in that they only reach PBFW who are coming to the facilities. To reach more, PISs and other strategies need to be conducted at community level.

CONCLUSIONS: Employing multiple, targeted demand creation strategies at facility level increases oral PrEP uptake by PBFW. However, this strategy will need to be complemented by community-based strategies targeting PBFW, their partners and other influencers.

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