Health Systems

Implementation Research on Introducing and Scaling Up Pre-Exposure Prophylaxis Prevention of HIV Infection within Family Planning/Contraceptive Services in South Africa

This study aims to identify implementation gaps and challenges related to integration of PrEP for HIV prevention in services where contraception is delivered and develop a strategy on how to address these challenges and enhance scale up.

The study will:- 1. Explore the coverage and readiness of PrEP delivery where contraceptive services are provided. 2. Identify feasibility, facilitating and impeding factors that influence the integration of contraception and PrEP services and sustainability at all levels of care. 3. Explore stakeholders’ knowledge and perceptions towards the integration of contraception and PrEP services. 4. Identify clients’ acceptability, perceived barriers and enablers of receiving PrEP where contraceptive services are provided, in order to understand factors that influence clients’ decision making about PrEP initiation and continuation in the context of integrated service delivery. 5. Draw upon findings to develop a strategy with stakeholders that addresses implementation gaps and challenges and the development of indicators to measure integration of PrEP and contraceptive services.

This study will be conducted in South Africa at multiple levels of organization: national, provincial, district (eThekwini District, KwaZulu-Natal [KZN] Province), primary health facilities, and community.

Study title Implementation Research on Introducing and Scaling Up Pre-Exposure Prophylaxis Prevention of HIV Infection within Family Planning/Contraceptive Services in South Africa
Funder WHO
Principal and Co-Principal investigators

Prof Jenni Smit (PI) 

Mags Beksinska (Co-PI)

Nzwakie Mosery (Co-PI)

 

Site National / Provincial

 

Nursing Resilience

 

Study title

Developing a resiliency intervention to support nurses engaged in the provision of HIV care (Phase I)

Study design  

This study will adapt, refine, and pilot test an existing stress management and resiliency-enhancing intervention (the Relaxation Response Resiliency Program; 3RP) for nurses providing HIV care in the public sector in SA. We will identify the ways in which the 3RP requires adaptation to meet the needs of nurses based on data collected from focus group discussions (FGDs) and adapt the intervention accordingly. We will enroll N=15-21 nurses to participate in FGDs (up to 3 groups of 5-7 nurses).

Funder

NIH –

Principal investigators

Dr Christina Psaros – Massachusetts General Hospital,

Prof Jenni Smit – Wits Maternal Adolescent and Child Health Research

Site

EThekwini clinics providing HIV care

 

 Completed Health Systems Studies

DIFFER: Diagonal Interventions to Fast-Forward Enhanced Reproductive Health
The “Diagonal Interventions to Fast Forward Enhanced Reproductive Health” (DIFFER) research project tests the hypothesis that combining vertical Sexual and Reproductive Health (SRH) interventions, such as services targeted to Female Sex Workers (FSW), with horizontal strengthening of health systems for SRH within existing health facilities, is synergistic, feasible, and likely to be more effective and cost-effective than providing them separately. In particular, the research activities will build capacity to implement interventions for FSW.  This multi-country study consisted of a consortium of three African, one Indian and two European partners. The research activities are being undertaken in the African sites (Durban, South Africa; Mombasa, Kenya; and Tete, Mozambique) and in Mysore India.  The formative research  including a detailed situational and policy analysis informed the development of site and context-specific intervention packages to strengthen SRH services. This study was completed in 2016, dissemination and publication of results is ongoing.

Funder/Sponsor: The European Union
Principal Investigator: Prof J Smit (MatCH Research)
Site: MatCH Research Commercial City Site and community  in central Durban
Collaborators: University of Ghent – International Centre for Reproductive Health (UG-ICRH), Belgium, Ashodaya Samithi (Ashodaya), India, International Centre for Reproductive Health Association, Kenya (ICRH-K), International Centre for Reproductive Health Association Mozambique (ICRH-M), Lifeline, Durban

 

Recreational Antiretroviral Use in South Africa
The  qualitative study  aimed to evaluate whoonga; the context of whoonga use, knowledge of ARV diversion for recreational use and unmet health need of whoonga users.  Using purposive sampling, a subset of whoonga users was invited from the South African National Council on Alcoholism and Drug Dependence (SANCA) Lulama Treatment Centre Durban (N=30) and a subset of key informants knowledgeable about whoonga (N=10) participated in semi-structured interviews about whoonga.  Whonga users aged 18 years and above, admitted voluntarily for inpatient substance use treatment at SANCA were included if  able and willing to provide informed consent and speak English or isiZulu.   Dissemination is ongoing and the results are currently being written up for publication.

Funder/Sponsor: Funded by NIH though CFAR grant
Principal Investigator: Prof J Smit
Site: SANCA Lulama Treatment Centre
Collaborators: Havard Medical School and Massachessetts General Hospital. SANCA Lulama Treatment Centre