Integrating Gender-Based Violence Screening and Support into the Research Clinic Setting: Experiences from an HIV Prevention Open-Label Extension Trial in Sub-Saharan Africa

Morgan Garcia; Sarah T Roberts; Ashley J Mayo; Rachel Scheckter; Leila E Mansoor; Thesla Palanee-Phillips; Krishnaveni Reddy; Yuthika Naidoo; Carolyne Agwau Akello; Zakir Gaffoor; Samantha Siva; Chenai Rushwaya; Kudzai Hlahla; Jane Jambaya; Rujeko Makoni; Evans Kachale; Margret Ndovie; Jabulisile Zuma; Elizabeth T Montgomery; MTN-025/HOPE study team

doi:10.1007/s10461-022-03864-6

Integrating Gender-Based Violence Screening and Support into the Research Clinic Setting: Experiences from an HIV Prevention Open-Label Extension Trial in Sub-Saharan Africa

AIDS Behav. 2023 Apr;27(4):1277-1286. doi: 10.1007/s10461-022-03864-6. Epub 2022 Sep 30.

Authors

Morgan Garcia^{1

2}, Sarah T Roberts³, Ashley J Mayo⁴, Rachel Scheckter⁴, Leila E Mansoor⁵, Thesla Palanee-Phillips^{6

7}, Krishnaveni Reddy⁶, Yuthika Naidoo⁶, Carolyne Agwau Akello⁸, Zakir Gaffoor⁹, Samantha Siva⁹, Chenai Rushwaya¹⁰, Kudzai Hlahla¹⁰, Jane Jambaya¹⁰, Rujeko Makoni¹⁰, Evans Kachale¹¹, Margret Ndovie¹², Jabulisile Zuma¹³, Elizabeth T Montgomery³; MTN-025/HOPE study team

Affiliations

¹ Global Health Population and Nutrition, FHI 360, Durham, NC, USA. mgarcia@fhi360.org.
² Global Health Population and Nutrition, FHI 360, 359 Blackwell St, Ste 200, Durham, NC, 27701, USA. mgarcia@fhi360.org.
³ Women's Global Health Imperative (WGHI) RTI International, Berkeley, CA, USA.
⁴ Global Health Population and Nutrition, FHI 360, Durham, NC, USA.
⁵ Centre for the AIDS Programme of Research in South Africa (CAPRISA), University of KwaZulu-Natal, Durban, South Africa.
⁶ Faculty of Health Sciences, Wits Reproductive Health and HIV Institute (Wits RHI), University of the Witwatersrand, Johannesburg, South Africa.
⁷ University of Washington School of Public Health, Seattle, WA, USA.
⁸ Makerere University-Johns Hopkins University (MU-JHU) Research Collaboration, Kampala, Uganda.
⁹ HIV Prevention Research Unit (HPRU), South African Medical Research Council (SAMRC), Durban, South Africa.
¹⁰ University of Zimbabwe Clinical Trials Research Centre, Harare, Zimbabwe.
¹¹ College of Medicine - Johns Hopkins Bloomberg School of Public Health, Blantyre, Malawi.
¹² University of North Carolina Project, Lilongwe, Malawi.
¹³ Desmond Tutu HIV Foundation (DTHF) - Emavundleni Clinical Research Site, Cape Town, South Africa.

Abstract

HIV and gender-based violence (GBV) are syndemic in sub-Saharan Africa and provision of support for participants who disclose GBV constitutes part of comprehensive care. Consequently, a process was undertaken to develop, implement, and evaluate standard operating procedures (SOPs) in MTN-025/HOPE, a study of the dapivirine vaginal ring for HIV prevention. The SOP was developed using needs assessment surveys in addition to World Health Organization (WHO) guidelines and other literature. Sites tailored and implemented the SOP through HOPE implementation. At study end, staff reported increased training 32/35 (91.43%); improved confidence (18/26; 69.23%); and improved vicarious trauma prevention onsite (17/28; 60.71%). Leadership reported increased staff competence in GBV response. Obstacles included limited referral organizations and time for follow-up, continued training needs, and cultural norms. Development and implementation of an SOP is a feasible strategy to build a GBV response to improve health systems and support sustained effective use of HIV prevention products.

Keywords: Dapivirine vaginal ring; Gender-based violence response; HIV prevention; Referral networks; Vicarious trauma.

MeSH terms

Acquired Immunodeficiency Syndrome*
Africa South of the Sahara / epidemiology
Female
Gender-Based Violence* / prevention & control
HIV Infections* / prevention & control
Humans
Surveys and Questionnaires

Abstract

MeSH terms

Grants and funding