- DREAMS goes digital: Adapting PrEP delivery for adolescent girls and young women during COVID-19 in Kenya
- Target clients
- Building blocks of the Project PrEP service – Pre COVID-19
- PrEP screening and initiation visit
- PrEP screening and initiation visit
- PrEP continuation: Routine clinical follow-up
- COVID-19 related adaptations to model:
- Building blocks of the Project PrEP service – post COVID-19
- PrEP screening and initiation visit
- PrEP initial follow-up
- More...
The DREAMS project is embedded in the Afya Ziwani project based in Homa Bay, Kisumu, Migori and Nyamira in Western Kenya and provides comprehensive HIV services across the cascade, focusing on adolescent girls and young women (AGYW), fisherfolk and key populations.
Prior to COVID-19, PrEP was offered through the DREAMS project in safe spaces and health facilities. PrEP services included PrEP education, initiation and support groups.
Impact: From March to December 2017, 37% of adolescent girls and young women who initiated PrEP through the DREAMS project were still using it at three months. Recent qualitative research on the DREAMS project found that, amongst other factors, decentralization of PrEP support and delivery, use of peer mentors and the safe space model were facilitators for PrEP uptake.
Target clients
Adolescent girls and young women
Building blocks of the Project PrEP service – Pre COVID-19
PrEP screening and initiation visit
What
Same day HIV testing
Risk assessment and plan
PrEP counselling
When
Same day
Where
Safe space (counselling)
Health facility (screening and initiation)
Who
Physician (exam/prescription)
Nurse
Counselling (AGYW DREAMS mentor; community health worker)
PrEP screening and initiation visit
What
HIV testing
PrEP counselling
When
Month 1
Where
Health facility
Who
Physician (exam/prescription)
Nurse
PrEP continuation: Routine clinical follow-up
What
Same day HIV testing
Integrated family planning & STI services
Risk assessment and plan
PrEP counselling
When
Every 3 months
Where
Health facility
Who
Physician (exam/prescription)
Nurse
Counselling (AGYW DREAMS mentor; community health worker)
COVID-19 related adaptations to model:
In order to continue the provision of essential services (including PrEP) during COVID-19 movement restrictions, temporary mobile and virtual safe spaces were established. This meant that clients could access information and services virtually (calls, SMS, WhatsApp), including outreach, risk screening, PrEP initiation and follow-up. PrEP refills took place at the client’s preferred location and included the possibility for home-delivery.
Building blocks of the Project PrEP service – post COVID-19
PrEP screening and initiation visit
What
Same day HIV testing
Risk assessment and plan
PrEP counselling
When
Same day
Where
Virtual or mobile Safe space (counselling)
Health facility (screening and initiation)
Who
Physician (exam/prescription)
Nurse
Counselling (AGYW DREAMS mentor; community health worker)
PrEP initial follow-up
What
HIV testing
PrEP counselling
When
Month 1
Where
Health facility
Who
Physician (exam/prescription)
Nurse
PrEP continuation: Routine clinical follow-up
What
Same day HIV testing
Integrated family planning & STI services
Risk assessment and plan
PrEP counselling
When
Every 3 months
Where
Health facility (if clinical follow-up required)
Mobile safe space (if no clinical follow-up required)
Home (if no clinical follow-up required)
Who
Physician (exam/prescription)
Nurse
Counselling (AGYW DREAMS mentor; community health worker)
