{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T10:46:33Z","timestamp":1772966793292,"version":"3.50.1"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,2,5]],"date-time":"2023-02-05T00:00:00Z","timestamp":1675555200000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP10556051"],"award-info":[{"award-number":["OPP10556051"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["K99MH123369"],"award-info":[{"award-number":["K99MH123369"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["R00MH118134"],"award-info":[{"award-number":["R00MH118134"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["R01MH095507"],"award-info":[{"award-number":["R01MH095507"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>HIV pre\u2010exposure prophylaxis (PrEP) is an essential prevention strategy being scaled up for priority populations in Kenya, including for HIV serodiscordant couples. The COVID\u201019 pandemic posed challenges to PrEP rollout. We conducted a qualitative study of PrEP providers to understand how clinics adjusted PrEP delivery during the COVID\u201019 pandemic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Since 2017, the Partners Scale\u2010Up Project has integrated PrEP into 25 HIV clinics in Central and Western Kenya. We conducted qualitative interviews with 40 purposively sampled clinic personnel. We interviewed personnel once during the first pandemic wave (May\u2013Aug 2020) and again after some decline in COVID\u201019 rates (Nov\u2013Jan 2021). We analysed data using inductive memo\u2010writing and summarized data by themes along the PrEP delivery cascade, guided by the Framework for Reporting Adaptation and Modifications (FRAME).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We interviewed 27 clinical officers, five nurses, four health records and information officers, and four counsellors from Central (<jats:italic>n<\/jats:italic>\u00a0=\u00a020) and Western (<jats:italic>n<\/jats:italic>\u00a0=\u00a020) Kenya. About half (<jats:italic>n<\/jats:italic>\u00a0=\u00a019) were female, with a median age of 32 (IQR: 29\u201334) and 2.3 years of experience delivering PrEP (IQR: 2\u20133). All participants reported clinic changes in PrEP demand creation and service delivery during the pandemic. Modifications occurred during PrEP implementation and sustainment phases, were partly reactive to the pandemic and also facilitated by interim Ministry of Health guidance on PrEP delivery during COVID, and were made by PrEP delivery teams, clients and clinic managers. Commonly reported modifications included dispensing multiple\u2010month PrEP refills, intensifying phone\u2010based client engagement and collaborating with other HIV clinics to ensure that clients with prolonged stays in other regions could continue to access PrEP. Some clinics also adopted practices to streamline visits, such as within clinical\u2010room PrEP dispensing, pre\u2010packing PrEP and task\u2010shifting. Most providers liked these changes and hoped they would continue after the pandemic subsides.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>COVID\u201019 served as a catalyst for PrEP delivery innovations in Kenya. HIV clinics successfully and rapidly adapted their PrEP demand creation, refill and retention strategies to promote PrEP uptake and effective use. These modified implementation strategies highlight opportunities to streamline the delivery of PrEP, as well as other HIV and chronic care services, and strengthen engagement with populations post\u2010pandemic.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.26055","type":"journal-article","created":{"date-parts":[[2023,2,5]],"date-time":"2023-02-05T17:09:08Z","timestamp":1675616948000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Provider perspectives on service delivery modifications to maintain access to HIV pre\u2010exposure prophylaxis during the COVID\u201019 pandemic: qualitative results from a PrEP implementation project in Kenya"],"prefix":"10.1002","volume":"26","author":[{"given":"Jennifer","family":"Velloza","sequence":"first","affiliation":[{"name":"Department of Epidemiology &amp; Biostatistics University of California San Francisco San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie D.","family":"Roche","sequence":"additional","affiliation":[{"name":"Public Health Division Fred Hutchinson Cancer Research Center Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmah J.","family":"Owidi","sequence":"additional","affiliation":[{"name":"Partners in Health and Research Development Thika Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth M.","family":"Irungu","sequence":"additional","affiliation":[{"name":"Jhpiego Nairobi Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annabell","family":"Dollah","sequence":"additional","affiliation":[{"name":"Washington State University \u2013 Global Health Kenya Nairobi Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benn","family":"Kwach","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute Kisumu Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas B.","family":"Thuo","sequence":"additional","affiliation":[{"name":"Partners in Health and Research Development Thika Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer F.","family":"Morton","sequence":"additional","affiliation":[{"name":"Department of Global Health University of Washington Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nelly","family":"Mugo","sequence":"additional","affiliation":[{"name":"Partners in Health and Research Development Thika Kenya"},{"name":"Department of Global Health University of Washington Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth A.","family":"Bukusi","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute Kisumu Kenya"},{"name":"Department of Global Health University of Washington Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabrielle","family":"O'Malley","sequence":"additional","affiliation":[{"name":"Department of Global Health University of Washington Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth","family":"Ngure","sequence":"additional","affiliation":[{"name":"Department of Global Health University of Washington Seattle Washington USA"},{"name":"Department of Community Health Jomo Kenyatta University of Agriculture and Technology Nairobi Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jared M.","family":"Baeten","sequence":"additional","affiliation":[{"name":"Department of Global Health University of Washington Seattle Washington USA"},{"name":"Gilead Sciences Foster City California USA"},{"name":"Department of Medicine University of Washington Seattle Washington USA"},{"name":"Department of Epidemiology University of Washington Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth K.","family":"Mugwanya","sequence":"additional","affiliation":[{"name":"Department of Global Health University of Washington Seattle Washington USA"},{"name":"Department of Epidemiology University of Washington Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"for the Partners Scale\u2010Up Project Team","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,2,5]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0000000000000567"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(18)30215-7"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.19.1.21348"},{"key":"e_1_2_12_5_1","volume-title":"Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key 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