Le Kip Kip: A Campaign to Change Social Norms and Build Sustainable Demand for PrEP Among Women in South Africa

Johns Hopkins Bloomberg School of Public Health

Status: Completed

Conditions: Pre-exposure Prophylaxis; HIV Infections

Treatments: Other: Standard of Care; Behavioral: PrEP Champions; Behavioral: Social Media Campaign; Behavioral: Community Mobilization

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT05417620

R01MH121161 (U.S. NIH Grant/Contract)

90089975

Details and patient eligibility

About

The purpose of this study is to evaluate the impact of a social media campaign and community engagement activities to promote pre-exposure prophylaxis (PrEP) use among young women and to influence community norms around PrEP in South Africa. To do this, the investigative team will analyze PrEP initiation and retention data from the study's implementing partner, TB HIV Care, a non-profit organization providing PrEP to marginalized young women in South Africa. The effect of the social media campaign and community engagement will be tested using a short duration cluster randomized trial (CRT).

Full description

The cluster randomized trial (CRT) will not engage in PrEP provision to individuals, but instead employs geographical regions to serve as units of randomization where social media content and community engagement will be targeted. TB HIV Care employs a large team to provide routine service delivery while the CRT tests strategies including a social media campaign and community engagement that may amplify PrEP uptake and persistence among the community, leveraging the programme infrastructure to actually provide services as it is already doing. Embedding strategies within the programme ensures that the existing results come from real world contexts and focuses on implementation of support strategies rather than clinical care provision. The CRT will be implemented across 10 districts, with 5 districts serving as control sites and 5 as intervention sites.

Enrollment: 601 patients

Sex: Female

Ages: 15+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Eligible to take PrEP per TB HIV Care programmatic criteria
• Engaged in TB HIV Care HIV prevention program

Exclusion criteria

• Not eligible for PrEP (not at risk for HIV) per TB HIV Care programmatic criteria

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Factorial Assignment

Masking: None (Open label)

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601 participants in 5 patient groups

Standard of Care

Other group

Description:

Full-time peer educators employed by the TB HIV Care programme to engage women, layer PrEP promotion across prevention programs, and implement "refer a friend" strategies, information, education and communication (IEC) materials, service user testimonials, risk reduction posters to increase young women's perception of risk, working after hours/weekends to reach young women, working with school governing bodies, and door-to-door outreach.

Treatment:

Other: Standard of Care

Enhanced social media campaign

Experimental group

Description:

Social media campaign which will be disseminated on Facebook, Instagram, and WhatsApp with targeted ads/promotion of materials in intervention districts.

Treatment:

Behavioral: Social Media Campaign

Enhanced social media campaign + PrEP champions

Experimental group

Description:

Venue-based peers who will provide PrEP information, share personal experiences with PrEP, and refer young women to TB HIV Care to receive PrEP if interested in addition to the enhanced social media campaign.

Treatment:

Behavioral: PrEP Champions

Behavioral: Social Media Campaign

Enhanced social media campaign + Community mobilization

Experimental group

Description:

Peers will work within wards to organize and attend community meetings to share PrEP information and facilitate discussions with young women, male partners, family members, and other community members in addition to the enhanced social media campaign.

Treatment:

Behavioral: Community Mobilization

Behavioral: Social Media Campaign

Enhanced social media campaign + PrEP champions + Community mobilization

Experimental group

Description:

Clusters in this arm will receive both the PrEP champion and community mobilization interventions in addition to the enhanced social media campaign.

Treatment:

Behavioral: Community Mobilization

Behavioral: PrEP Champions

Behavioral: Social Media Campaign