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COMMUNITY-BASED, PEER-LED SRH SERVICES INCREASE COVERAGE in AYP (YATHU YATHU TRIAL)
Topics in Antiviral Medicine ; 30(1 SUPPL):282, 2022.
Article in English | EMBASE | ID: covidwho-1880721
ABSTRACT

Background:

Ensuring adolescents and young people (AYP) have access to comprehensive sexual and reproductive health services (SRHS), including HIV testing and prevention, is critical if we are to reduce HIV incidence and improve wellbeing. Following HPTN 071 (PopART) in Zambia, AYP stated that they needed improved access to SRHS and that these services should be provided from locations other than the health facility. The Yathu Yathu ("For us, by us") trial was co-developed from this request. We report on a secondary outcome of this trial, coverage of 6 predefined key SRHS (HIV testing, ART initiation, PrEP initiation, condom collection, VMMC and hormonal contraception) by trial arm

Methods:

Yathu Yathu is a cluster randomized trial conducted 2019-2021 in 2 urban communities in Lusaka, Zambia. The communities were divided into 20 zones which were randomly allocated to the Yathu Yathu intervention (YY) or standard of care (SoC) arms. In intervention zones, a YY hub, staffed by supervised peers, provided SRHS. In both arms, a census was conducted in 2019 where AYP (15-24 years) were invited to participate in the trial. Each was offered a Yathu Yathu card, which allowed them to collect "prevention points" for accessing SRHS at the health facility (SoC arm) or at the hub and health facility (YY arm). In both arms, points could be exchanged for health rewards, thus acting as an incentive to access services and as a tool to record service use. We use this YY card data to assess coverage of key SRHS

Results:

Of the 40,864 AYP enumerated, 29,370 (71.9%) consented to participate and accepted a Yathu Yathu card (14, 872, 71.6% YY arm, 14,498, 72.2% SoC arm). In the YY arm, 9493/14878 (63.8%) accessed at least one key service compared to 775/14498 (5.4%) in the SoC arm (adj RR 12.5;95%CI 9.9-15.8, p<0.001). Results were similar by age and sex (Table 1). The median number of visits in the YY arm was 1 (IQR 0-31) compared to 0 (IQR 0-0) in SoC. Of those accessing any service, HIV testing was the most common service in both arms (8841/9493 (93.1%) and 568/775 (73.3%), respectively) followed by collection of condoms (4701/9493 (49.5%) and 386/775 (49.8%) respectively)

Conclusion:

The Yathu Yathu intervention increased uptake of key SRHS, especially HIV testing. While YY hubs closed for 3months during COVID-19, health facility attendance may have also decreased thus affecting the difference in coverage. Nonetheless, our findings demonstrate the potential of peer-led community hubs to increase coverage of SRHS.
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Collection: Databases of international organizations Database: EMBASE Type of study: Randomized controlled trials Language: English Journal: Topics in Antiviral Medicine Year: 2022 Document Type: Article

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Collection: Databases of international organizations Database: EMBASE Type of study: Randomized controlled trials Language: English Journal: Topics in Antiviral Medicine Year: 2022 Document Type: Article