Jhpiego, a global health nonprofit and Johns Hopkins University affiliate, will scale up a highly effective HIV prevention strategy—a daily dose of an antiretroviral pill for highly vulnerable individuals that reduces their chances of contracting the virus.
The Bill & Melinda Gates Foundation awarded Jhpiego $22.3 million over four years to scale up oral pre-exposure prophylaxis, known as PrEP, that studies have shown is as effective at preventing HIV as oral contraceptives are at preventing pregnancy when taken as directed.
Working in strong partnership with the government of Kenya, Jhpiego will direct the Bridge to Scale project aimed at reaching 20,000 Kenyans who are most vulnerable to HIV infection. That includes adolescent girls and young women, among others, many of whom have difficulty accessing HIV prevention and treatment services because of stigma and cultural and social barriers.
The key goals of the project—the first of its kind to deliver PrEP widely across a health system while promoting a sustainable service delivery model—is to learn and develop new ways of ensuring that lifesaving interventions like this one reach those most likely to benefit, and to assess barriers to services as health providers integrate delivery of such interventions into routine health care practices.
Kenya and South Africa are the first African countries moving forward with a PrEP strategy, and to date they have employed small-scale demonstration projects to start introducing PrEP. The Bridge to Scale initiative, perhaps the largest donor-funded program of its kind, offers a unique opportunity to develop creative strategies for implementation of a simple, evidence-based intervention for protection from HIV infection in a complex, real-world environment.
A recognized expert at translating research into practice through the ongoing voluntary medical male circumcision scale-up, Jhpiego has been working in more than a dozen African countries to help prevent the spread of HIV. The Bridge to Scale project is the latest in its suite of HIV prevention, care, and treatment programs.
"We are thrilled to be leading this very exciting project that puts health care into the hands of those who need it most," said Leslie Mancuso, Jhpiego's president and CEO. "Oral PrEP is a breakthrough HIV prevention strategy because it gives any individual the power to protect themselves rather than having to rely on a partner or partners to use condoms or adhere to their HIV medicine.
"Like oral contraceptives, PrEP only works when taken, so it requires a commitment on the part of the client," she added. "That poses a challenge and an opportunity to develop approaches to client adherence and retention that work best for the individual and the community."
Jhpiego will be joined in this new project by the National AIDS and STIs Control Program (NASCOP), International Center for Reproductive Health Kenya (ICRHK), Population Services Kenya (PSK), and Avenir Health.