TENDAI4PrEP A Problem-Solving Program to Help Pregnant Women in Zimbabwe Use PrEP and Overcome Barriers Improving HIV Prevention by Supporting Patients, Partners, and Healthcare Providers

What this Trial Is About

This research aims to develop a multi-level intervention called TENDAI4PrEP, adapted from the TENDAI program, to improve uptake and persistence of oral pre-exposure prophylaxis PrEP among pregnant persons in Zimbabwe. The study addresses the urgent public health need due to Zimbabwes high HIV prevalence, especially among cisgender women of reproductive age, and aims to overcome barriers such as psychological distress, stigma, low partner support, and limited provider knowledge. The intervention involves 4-5 problem-solving sessions including one with a partner and an optional postpartum booster, incorporating PrEP education, psychoeducation, and a culturally adapted Life Steps approach. Participants are randomized to either the TENDAI4PrEP intervention or enhanced treatment as usual ETAU, which includes monthly antenatal care visits and educational pamphlets. Providers at the clinics also receive training to improve PrEP knowledge and reduce stigma. Participants will be involved in assessments over approximately five months post-baseline, including evaluations of feasibility and acceptability of the intervention and provider training. Measurements include self-reported PrEP adherence, psychological distress, PrEP persistence, and changes in provider knowledge and stigma. Qualitative interviews with providers and administrators will explore implementation outcomes to prepare for larger-scale testing.

Adaptation of an Intervention Addressing Barriers to PrEP Use Among Pregnant Women in Zimbabwe