Trial Outcomes & Findings for PrEPARE: PrEP in Pregnancy, Accelerating Reach and Efficiency (NCT NCT04712994)

NCT ID: NCT04712994

Last Updated: 2025-01-08

Results Overview

Proportion of women who are screened for PrEP / total women receiving antenatal or postnatal services

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

1958 participants

Primary outcome timeframe

6 months

Results posted on

2025-01-08

Participant Flow

The enrollment number in the protocol section (1958) includes the sum of participants who started in the participant flow module below (1919), as well as the 39 additional health care workers who provided cross-sectional data in the intervention group during the intervention period. There was no drop-off between consent and enrollment.

Unit of analysis: Facilities

Participant milestones

Participant milestones
Measure
PrEP Optimization Strategies
Four facilities will be assigned to the intervention group. The intervention group will receive a pre-identified package of interventions (PrEP video counselling, HIV Self-Testing, and optimized delivery and prescription processes). PrEP Optimization Interventions: A bundle of strategies (video-based PrEP counselling, HIV Self-Testing \[HIVST\] for women undergoing repeat HIV testing, and optimized PrEP delivery and prescription processes) will be implemented in the intervention group.
Comparator
Four facilities will be assigned to the comparator group.
Baseline Period (3 Months)
STARTED
480 4
480 4
Baseline Period (3 Months)
COMPLETED
480 4
480 4
Baseline Period (3 Months)
NOT COMPLETED
0 0
0 0
Intervention Period (3 Months)
STARTED
481 4
479 4
Intervention Period (3 Months)
COMPLETED
481 4
479 4
Intervention Period (3 Months)
NOT COMPLETED
0 0
0 0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

PrEPARE: PrEP in Pregnancy, Accelerating Reach and Efficiency

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
PrEP Optimization Strategies -- Baseline
n=480 Participants
Four facilities will be assigned to the intervention group. The intervention group will receive a pre-identified package of interventions (PrEP video counselling, HIV Self-Testing, and optimized delivery and prescription processes). PrEP Optimization Interventions: A bundle of strategies (video-based PrEP counselling, HIV Self-Testing \[HIVST\] for women undergoing repeat HIV testing, and optimized PrEP delivery and prescription processes) will be implemented in the intervention group.
Comparator -- Baseline
n=480 Participants
Four facilities will be assigned to the comparator group.
PrEP Optimization Strategies -- Intervention Period
n=481 Participants
Four facilities will be assigned to the intervention group. The intervention group will receive a pre-identified package of interventions (PrEP video counselling, HIV Self-Testing, and optimized delivery and prescription processes). PrEP Optimization Interventions: A bundle of strategies (video-based PrEP counselling, HIV Self-Testing \[HIVST\] for women undergoing repeat HIV testing, and optimized PrEP delivery and prescription processes) will be implemented in the intervention group.
Comparator -- Intervention Period
n=479 Participants
Four facilities will be assigned to the comparator group.
Total
n=1920 Participants
Total of all reporting groups
Age, Continuous
24 years
n=5 Participants
25 years
n=7 Participants
25 years
n=5 Participants
25 years
n=4 Participants
25 years
n=21 Participants
Sex: Female, Male
Female
480 Participants
n=5 Participants
480 Participants
n=7 Participants
481 Participants
n=5 Participants
479 Participants
n=4 Participants
1920 Participants
n=21 Participants
Sex: Female, Male
Male
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Race (NIH/OMB)
Black or African American
480 Participants
n=5 Participants
480 Participants
n=7 Participants
481 Participants
n=5 Participants
479 Participants
n=4 Participants
1920 Participants
n=21 Participants
Race (NIH/OMB)
White
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Region of Enrollment
Kenya
480 participants
n=5 Participants
480 participants
n=7 Participants
481 participants
n=5 Participants
479 participants
n=4 Participants
960 participants
n=21 Participants

PRIMARY outcome

Timeframe: 6 months

Population: The total population includes cross sectional groups from 2 time periods. The population analyzed above is a summation of the participants analyzed in the 2 periods. This is a difference in differences design with 2 time periods.

Proportion of women who are screened for PrEP / total women receiving antenatal or postnatal services

Outcome measures

Outcome measures
Measure
PrEP Optimization Strategies
n=961 Participants
Four facilities will be assigned to the intervention group. The intervention group will receive a pre-identified package of interventions (PrEP video counselling, HIV Self-Testing, and optimized delivery and prescription processes). PrEP Optimization Interventions: A bundle of strategies (video-based PrEP counselling, HIV Self-Testing \[HIVST\] for women undergoing repeat HIV testing, and optimized PrEP delivery and prescription processes) will be implemented in the intervention group.
Comparator
n=958 Participants
Four facilities will be assigned to the comparator group.
PrEP Penetration
Baseline
30 Participants
17 Participants
PrEP Penetration
Intervention
46 Participants
8 Participants

PRIMARY outcome

Timeframe: 6 months

Population: The total population includes cross sectional groups from 2 time periods. The population analyzed above is a summation of the participants analyzed in the 2 periods. This is a difference in differences design with 2 time periods.

Proportion of women who receive all PrEP specific steps in a visit: HIV testing, HIV risk screening, PrEP counseling

Outcome measures

Outcome measures
Measure
PrEP Optimization Strategies
n=961 Participants
Four facilities will be assigned to the intervention group. The intervention group will receive a pre-identified package of interventions (PrEP video counselling, HIV Self-Testing, and optimized delivery and prescription processes). PrEP Optimization Interventions: A bundle of strategies (video-based PrEP counselling, HIV Self-Testing \[HIVST\] for women undergoing repeat HIV testing, and optimized PrEP delivery and prescription processes) will be implemented in the intervention group.
Comparator
n=958 Participants
Four facilities will be assigned to the comparator group.
PrEP Fidelity
Baseline
14 Participants
4 Participants
PrEP Fidelity
Intervention
28 Participants
5 Participants

PRIMARY outcome

Timeframe: 6 months

Population: The total population includes cross sectional groups from 2 time periods. The population analyzed above is a summation of the participants analyzed in the 2 periods. This is a difference in differences design with 2 time periods.

Time (minutes) spent receiving services from health care works

Outcome measures

Outcome measures
Measure
PrEP Optimization Strategies
n=384 Participants
Four facilities will be assigned to the intervention group. The intervention group will receive a pre-identified package of interventions (PrEP video counselling, HIV Self-Testing, and optimized delivery and prescription processes). PrEP Optimization Interventions: A bundle of strategies (video-based PrEP counselling, HIV Self-Testing \[HIVST\] for women undergoing repeat HIV testing, and optimized PrEP delivery and prescription processes) will be implemented in the intervention group.
Comparator
n=384 Participants
Four facilities will be assigned to the comparator group.
Timeliness of Services
Baseline
18 minutes
Interval 12.0 to 36.0
16 minutes
Interval 10.0 to 33.0
Timeliness of Services
Intervention
17 minutes
Interval 11.0 to 29.0
14 minutes
Interval 9.0 to 27.5

PRIMARY outcome

Timeframe: 6 months

Population: The total population includes cross sectional groups from 2 time periods. The population analyzed above is a summation of the participants analyzed in the 2 periods. This is a difference in differences design with 2 time periods.

Time (minutes) spent waiting to receive services

Outcome measures

Outcome measures
Measure
PrEP Optimization Strategies
n=384 Participants
Four facilities will be assigned to the intervention group. The intervention group will receive a pre-identified package of interventions (PrEP video counselling, HIV Self-Testing, and optimized delivery and prescription processes). PrEP Optimization Interventions: A bundle of strategies (video-based PrEP counselling, HIV Self-Testing \[HIVST\] for women undergoing repeat HIV testing, and optimized PrEP delivery and prescription processes) will be implemented in the intervention group.
Comparator
n=384 Participants
Four facilities will be assigned to the comparator group.
Waiting Time
Intervention
55 minutes
Interval 31.0 to 80.0
29 minutes
Interval 14.0 to 46.5
Waiting Time
Baseline
49 minutes
Interval 22.5 to 77.0
37 minutes
Interval 14.5 to 74.0

PRIMARY outcome

Timeframe: 6 months

Population: This outcome was assessed on a group of 39 HCW who were involved in delivering the implementation strategy package. These are not a subset of the women enrolled in the study, hence the numbers are not concordant.

Total on 4 item Acceptability of Intervention Measures (AIM) score, 1 (Completely disagree) to 5 (Completely Agree) Likert scale. The minimum score on the 4 items is 4 points (scoring 1 on each of the 4 items) while the maximum is 20 points (scoring 5 on each of the 4 items). A higher score indicates a better outcome. The sub-scores on each of the 4 items are summed.

Outcome measures

Outcome measures
Measure
PrEP Optimization Strategies
n=39 Participants
Four facilities will be assigned to the intervention group. The intervention group will receive a pre-identified package of interventions (PrEP video counselling, HIV Self-Testing, and optimized delivery and prescription processes). PrEP Optimization Interventions: A bundle of strategies (video-based PrEP counselling, HIV Self-Testing \[HIVST\] for women undergoing repeat HIV testing, and optimized PrEP delivery and prescription processes) will be implemented in the intervention group.
Comparator
Four facilities will be assigned to the comparator group.
HCW Acceptability
20.0 score on a scale
Interval 16.0 to 20.0

PRIMARY outcome

Timeframe: 6 months

Population: This outcome was assessed on a group of 39 HCW who were involved in delivering the implementation strategy package. These are not a subset of the women enrolled in the study, hence the numbers are not concordant.

Total on 4 item Intervention Appropriateness Measure (IAM) score, 1 (Completely disagree) to 5 (Completely Agree) Likert scale. The minimum score on the 4 items is 4 points (scoring 1 on each of the 4 items) while the maximum is 20 points (scoring 5 on each of the 4 items). A higher score indicates a better outcome. The sub-scores on each of the 4 items are summed.

Outcome measures

Outcome measures
Measure
PrEP Optimization Strategies
n=39 Participants
Four facilities will be assigned to the intervention group. The intervention group will receive a pre-identified package of interventions (PrEP video counselling, HIV Self-Testing, and optimized delivery and prescription processes). PrEP Optimization Interventions: A bundle of strategies (video-based PrEP counselling, HIV Self-Testing \[HIVST\] for women undergoing repeat HIV testing, and optimized PrEP delivery and prescription processes) will be implemented in the intervention group.
Comparator
Four facilities will be assigned to the comparator group.
Health Care Worker (HCW) Appropriateness
19.5 score on a scale
Interval 16.0 to 20.0

PRIMARY outcome

Timeframe: 6 months

Population: The total population includes cross sectional groups from 2 time periods. The population analyzed above is a summation of the participants analyzed in the 2 periods. This is a difference in differences design with 2 time periods.

Total on 6 item exit survey of clients to assess their satisfaction with services received at the facility, 1 (worse) to 4 (better) scale. The minimum score on the 6 items is 6 points (scoring 1 on each of the 6 items) while the maximum is 24 points (scoring 4 on each of the 6 items). A higher score indicates a better outcome. The sub-scores on each of the 4 items are summed.

Outcome measures

Outcome measures
Measure
PrEP Optimization Strategies
n=961 Participants
Four facilities will be assigned to the intervention group. The intervention group will receive a pre-identified package of interventions (PrEP video counselling, HIV Self-Testing, and optimized delivery and prescription processes). PrEP Optimization Interventions: A bundle of strategies (video-based PrEP counselling, HIV Self-Testing \[HIVST\] for women undergoing repeat HIV testing, and optimized PrEP delivery and prescription processes) will be implemented in the intervention group.
Comparator
n=958 Participants
Four facilities will be assigned to the comparator group.
Client Satisfaction
Baseline
21.0 score on a scale
Interval 19.0 to 23.0
23.0 score on a scale
Interval 20.0 to 23.0
Client Satisfaction
Intervention
23.0 score on a scale
Interval 21.0 to 23.0
23.0 score on a scale
Interval 20.0 to 24.0

SECONDARY outcome

Timeframe: 6 months

Population: The total population includes cross sectional groups from 2 time periods. The population analyzed above is a summation of the participants analyzed in the 2 periods. This is a difference in differences design with 2 time periods. This analysis population is a subset of the total because it only includes those who were offered PrEP, as noted in the denominator description of the indicator.

Proportion of women who accept PrEP among those offered

Outcome measures

Outcome measures
Measure
PrEP Optimization Strategies
n=34 Participants
Four facilities will be assigned to the intervention group. The intervention group will receive a pre-identified package of interventions (PrEP video counselling, HIV Self-Testing, and optimized delivery and prescription processes). PrEP Optimization Interventions: A bundle of strategies (video-based PrEP counselling, HIV Self-Testing \[HIVST\] for women undergoing repeat HIV testing, and optimized PrEP delivery and prescription processes) will be implemented in the intervention group.
Comparator
n=17 Participants
Four facilities will be assigned to the comparator group.
PrEP Uptake
Baseline
0 Participants
1 Participants
PrEP Uptake
Intervention
0 Participants
1 Participants

SECONDARY outcome

Timeframe: 6 months

Population: The total population includes cross sectional groups from 2 time periods. The population analyzed above is a summation of the participants analyzed in the 2 periods. This is a difference in differences design with 2 time periods. This analysis population is a subset of the total because it only includes those who were initially prescribed PrEP, as noted in the denominator description of the indicator.

Proportion of women who present for a refill among those initially prescribed PrEP

Outcome measures

Outcome measures
Measure
PrEP Optimization Strategies
n=36 Participants
Four facilities will be assigned to the intervention group. The intervention group will receive a pre-identified package of interventions (PrEP video counselling, HIV Self-Testing, and optimized delivery and prescription processes). PrEP Optimization Interventions: A bundle of strategies (video-based PrEP counselling, HIV Self-Testing \[HIVST\] for women undergoing repeat HIV testing, and optimized PrEP delivery and prescription processes) will be implemented in the intervention group.
Comparator
n=17 Participants
Four facilities will be assigned to the comparator group.
PrEP Continuation
Baseline
1 Participants
1 Participants
PrEP Continuation
Intervention
1 Participants
2 Participants

SECONDARY outcome

Timeframe: 6 months

Population: During preparatory activities for data collection, it was determined that it was not feasible to extract patient adherence information; this outcome was neither collected nor compared.

Proportion of women who have \>80 percent adherence to PrEP by pill count among those initially prescribed PrEP

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 6 months

Population: During preparatory activities for data collection, it was determined that it was not feasible to collect efficiency this outcome was neither collected nor compared.

Patient flow mapping to identify more efficient client flows with fewer transitions between physical spaces and providers

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 6 months

Population: The total population includes cross sectional groups from 2 time periods. The population analyzed above is a summation of the participants analyzed in the 2 periods. This is a difference in differences design with 2 time periods.

Number of participants with perfect knowledge on PrEP information questions based on content covered in counseling sessions

Outcome measures

Outcome measures
Measure
PrEP Optimization Strategies
n=961 Participants
Four facilities will be assigned to the intervention group. The intervention group will receive a pre-identified package of interventions (PrEP video counselling, HIV Self-Testing, and optimized delivery and prescription processes). PrEP Optimization Interventions: A bundle of strategies (video-based PrEP counselling, HIV Self-Testing \[HIVST\] for women undergoing repeat HIV testing, and optimized PrEP delivery and prescription processes) will be implemented in the intervention group.
Comparator
n=958 Participants
Four facilities will be assigned to the comparator group.
Client PrEP Knowledge
Baseline
5 Participants
0 Participants
Client PrEP Knowledge
Intervention
56 Participants
5 Participants

Adverse Events

PrEP Optimization Strategies

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Comparator

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Anjuli Wagner

University of Washington

Phone: 9784602331

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place