Do-PrEP

Development of an intervention to Optimise use of Pre-Exposure Prophylaxis (PrEP) to prevent HIV-acquisition in at-risk individuals living in Wales (DO-PrEP).

Background

People with human immunodeficiency virus (HIV) have weakened immune systems, with everyday infections and diseases eventually becoming life-threatening. Among other approaches to prevent developing HIV, people at risk of getting HIV can take medication usually used to treat HIV. This is commonly known as pre-exposure prophylaxis, or PrEP.

While PrEP has been shown to work when used as intended, there is currently limited information available for policy makers to decide whether PrEP should be made available through the NHS in Wales. As a result, PrEP is currently being made available for a limited time through sexual health clinics in Wales for people at risk of developing HIV.

Project aims

This project aims to find out:

1. How individuals living in Wales use PrEP;
2. How their use of PrEP relates to their behaviour;
3. How their use is related to accessing other health services;
4. If there are approaches that have previously been used in other settings to improve the use of PrEP, and if so, which approaches are best;
5. What people think are the main things stopping them from using PrEP at all, or using it appropriately, and approaches that might be helpful for improving the use of PrEP.

PrEP in Wales

Following this, an approach will be developed for improving the use of PrEP in Wales.

The project will be made up of four studies, or Workpackages (WP). WP1 will include 60 people who are being prescribed PrEP through sexual health clinics in Wales.

The bottles in which their PrEP medication is stored will be fitted with an electronic monitor. This will record the date and time that the bottle is opened. With this, a detailed understanding of patterns of PrEP use over a seven-month period will be obtained. In addition, sexual behaviour will be collected weekly using text messages.

WP2 will involve searching through scientific papers to find ones that report how effective different approaches are at improving PrEP use.

In WP3, between 20 and 30 people who took part in the WP1 study will be interviewed to find out how they felt about using PrEP and (if they stopped during WP1) why they stopped using PrEP and how they felt about stopping.

In WP4, an approach will be developed through a series of meetings with different people, including those who use PrEP, sexual health clinic staff, and policy makers. These people will discuss ways in which the developed approach can work in practice. Up to 10 people will also try out the approach and give feedback on whether it is something they (and others) would be willing to use.