As part of the Sustainable East Africa Research in Community Health (SEARCH) study, research was undertaken to develop cost-effective and scalable models for implementation of antiretroviral (ARV)-based HIV prevention products for young women in Kenya and Uganda.  Starting in 2016-2017, prior to nationwide scale-up of PrEP, PrEP was offered to 16 communities as part of an integrated programme of community-wide testing for HIV, hypertension, diabetes and malaria.  Persons who tested negative for HIV were offered PrEP with enhanced counselling for persons at elevated risk of acquiring HIV, same-day PrEP start and a flexible delivery system.   
 
Impact: Through the SEARCH study, almost one third of people at elevated risk for HIV acquisition initiated PrEP.  Seventy eight percent of clients who started PrEP had at least one follow-up visit / HIV test and more than half remained engaged in the programme at 72 weeks. 

Target clients

People at increased risk of HIV in rural Kenya and Uganda

Building blocks of the SEARCH PrEP delivery model

What

HIV testing 
Counselling 
PrEP refills 
Phone hotline to contact provider 

When

Baseline 
Week 4 
Week 12 
Every 12 weeks 

Where

Location preferred by client:  
Health facility 
Community sites: 
Home 
Beaches 
Trading centres 
Near schools 

Who

Clinic nurses 
Community nurses 
Supported by clinical officers