PrEP Messaging: Using radio to reach communities with oral PrEP messages

This story is part of a series of reports from the ongoing POWER Study, which is developing cost-effective and scalable models for PrEP delivery in Kenya and South Africa. AVAC and the University of Washington (UW) have teamed up to help answer questions from implementers rolling out PrEP in a variety of settings. Using qualitative stories from the UW PrEP projects, these blogs share lessons learned from the field and actionable insights for implementers developing strategies for delivering PrEP.

Joel Odondi must be doing something right. The former chaplain for a girls’ school has become a trusted expert on HIV prevention to radio listeners across Kenya – delivering messages that correct misinformation, counter myths, explain scientific concepts, and frame public health debates on PrEP and a host of other issues related to HIV. Keeping an ear out especially for what young women need to hear, Odondi uses a powerful combination of responsiveness, accuracy and credibility to get the job done.

Joel Odondi on the mic

It started ten years ago, when Odondi turned to a local radio station in Kisumu to get out messages about PrEP. The idea was to inform the community about research going on in their backyard on a new HIV prevention intervention, PrEP, and enroll people in the study, known as Partners PrEP, which also sponsored the show. Since that launch, the show was popular enough to continue through the open label extension study, demonstration study, and scale up program that is part of national roll out.

At the time, Odondi was part of the Partner’s PrEP team in Kisumu. It was a phase III placebo-controlled trial of daily oral TDF or TDF/FTC as PrEP for the prevention of HIV among heterosexual men and women in sero-discordant partnerships in Kenya and Uganda. Odondi saw that the providers and the scientists had developed a strong program to explain the study and how PrEP works. But that wasn’t enough.

Download a tool for radio engagement written by Odondi

“Those messages were not reaching the rural women, the village girls and that was a problem. Among other things, they needed information in their own language, Luo. I lost my sister to HIV and it was important to me to find a way to help make someone’s life better. I wanted to address issues of stigma and combat those myths with facts.”

Odondi started at two Luo speaking stations with hour-long shows where he would talk about PrEP, how it worked and who it was for. He talked about knowing your status and connecting with services. He confronted myths about the research process. He talked about why young people are vulnerable to HIV exposure. He talked about condom use, abstinence, voluntary medical male circumcision, morality and public health, and the importance of protecting young people as an investment in the future.

“Many of the participants [in PrEP demonstration projects] come from rural areas. It’s a challenge to get information to them. But they listen to the radio. And the radio gives you a kind of celebrity. It’s a kind of authority.”

Ten years later, Odondi is the Community Liaison Officer for the POWER study (Prevention Options for Women Evaluation Research) and the Lead Technical Advisor for Community Outreach for the Partners Scale-Up project operated out of KEMRI (Kenya Medical Research Institute). As part of his work on these projects, he has 18 shows a month on six different stations in three languages, Luo, English and Swahili, including stations in Nairobi that are heard across Kenya. Through all these stations his shows reach millions.

Each show starts with a 20-minute discussion between him and a station host on a prepared subject, the rest of the hour they open the phone lines and answer questions. The phone lines routinely fill up and stay full through the hour. His prepared remarks come from material he gets from the community through a couple of channels: he holds weekend workshops where he provides HIV prevention information to young women and they write down questions for him; the stations give their listeners a phone line where their questions and concerns are recorded for Odondi to review in advance of a show; and he provides a help line number over the air and promises that someone is always available to answer.

People call. A lot. Odondi is able to provide them with information about where to get PrEP in their area which has led to increased enrollments in both the POWER study and Partners Scale Up project.

“The same questions come up. The young people want to know if they are eligible to take PrEP. They want to know the side effects, if they have to take it forever, could they get an injection instead. Religious leaders ask me if PrEP will be abused, if it promotes promiscuity. One called into a show to say HIV was God’s punishment. I said ‘No. This is a health issue.’ When they bring the religious point of view, I can bring in a new point of view, a research literacy point of view.”

Sometimes he shapes his radio program based on new findings from the clinics he works with in his role in POWER and the Partners Scale Up project. “We saw a gap in HIV testing. So the station promoted my next show on the topic of testing with short spots on ‘What to do if you’re positive’ and ‘What to do if you’re negative’.”

When it comes to reminding people to take PrEP every day there are a few analogies he turns to again and again. “PrEP works if you take it. It’s the same if you want security — you have to lock your door every day. Condoms don’t work in your pocket. Wear a seatbelt every day for that one day you are in an accident.”

Odondi takes extra care in his messages to young people. He says it’s a real mistake to assume you know what they need. He attends community discussions about PrEP and listens to the voices of young women to stay up to date. But some parts of his message don’t change. “First I tell them they are special, their energy and spirit is our future. Then I tell them they [young women] are vulnerable and talk about condoms and sexual health and other risks. Finally, I tell them ‘you can be part of the solution,’ and invite their ideas. And then I listen.”

Additional Resources

  • Odondi has authored this brief outline on the benefits of radio as a tool for community engagement, complete with highlights of commonly asked questions and topics he covers.
  • Hear Joel Odondi explaining PrEP on the radio airwaves of KBC English, a Kenya-based news service.

logos for USAID, PEPFAR, and POWER

POWER (Cooperative Agreement AID-OAA-A-15-00034) is made possible by the generous support of the American people through the President’s Emergency Plan for AIDS Relief (PEPFAR) and the United States Agency for International Development (USAID). The contents do not necessarily reflect the view of USAID or the United States Government.

MPT Field Investments & Collaborations are Assets for Global Sexual Health

This post first appeared on the Initiative for MPTs’ blog.

Recently, on World Sexual Health Day, we at the IMPT reflect on how to work with partners to improve sexual health across the globe. There are many things that could be done, many different approaches, and many people we can work with towards this goal. Here, at the IMPT, we see multipurpose prevention technologies (MPTs) to be one such promising strategy with the potential to improve the sexual health – and lives – of women and their families across the globe.

Sexual and reproductive health risks, such as unintended pregnancy and sexually transmitted infections, including HIV, are intrinsically interlinked. Yet, the current mix of prevention options has fallen short in protecting the sexual health of millions of women. The innovative work being done to advance prevention science, including the development of MPTs, is essential to better meet sexual health needs and improve countless lives. The price of innovation is steep and the time horizon is long, but the end result has the potential to be game changing.

Sustained investment in prevention science is crucial for both the roll-out of existing prevention methods, as well as the development of new and effective technologies, like MPTs. The IMPT, led by the IMPT Secretariat, has partnered with the Resource Tracking for HIV Prevention R&D Working Group to monitor investments that support MPTs and the wider field of HIV prevention on an annual basis.

Since its inception in 2004, the Resource Tracking for HIV Prevention R&D Working Group, hereby referred to as the Working Group, has tracked US$17 billion of investments in biomedical HIV prevention research and analyzed funding trends across various prevention technologies, research stages, and sectors. This multi-tiered analysis of global investment flows is crucial for evaluating public policies, improving transparency, and furnishing facts for advocacy. As the HIV prevention toolbox has expanded, so has the mandate of the Working Group and the scope of our resource tracking efforts.

Substantial growth of the MPT pipeline coupled with an ever-present concern about the risk of STIs and unintended pregnancy in women, heralded the beginning of a partnership between the IMPT and the Working Group. From 2013 onwards, in a unique collaboration defined by a shared commitment to prevention science, knowledge and data-sharing, the IMPT and the Working Group have collated and analyzed close to US$142 million in funding for the advancement of MPT products. Expanding the scope of the Working Group’s original mandate, grants relevant to MPT R&D are also collected during the annual outreach to funders and implementers of HIV prevention science. This engenders a more efficient and streamlined method for data collection and the monitoring of field-wide investment trends.

Funding trends for MPT R&D reflect the rapid pace with which the field has grown – to cover two dozen new products and a 52 percent increase from 2013 levels when the resource tracking partnership began. While annual investments have averaged at US$37 million, overall funding dropped for the first time in 2016 by 14 percent to US$40 million. The US public sector remains the predominant funder of MPT research, primarily through the NIH and USAID, and accounting for 63 percent, 74 percent, and 67 percent of all overall investments in 2014, 2015, and 2016 respectively. Philanthropic investment in MPT research totaled US$4 million in 2016. Compared to the preceding year, private sector investment fell in 2016 and represented 10 percent of overall investment in MPT research.

The MPT field has seen a remarkable increase in investment in the last five years. However, the recent decrease in investment in prevention science, including MPTs, is concerning and should not be ignored. Advocates need to reinvigorate support for this important work and push for the investment needed to drive cutting edge and life changing science that will improve the sexual health of millions worldwide. The IMPT and the Working Group will continue to work together to monitor the progress of the fields and hope to see the needed resources committed to advancing prevention science and saving lives.

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Since 2000, the Resource Tracking for HIV Prevention R&D Working Group (formerly the HIV Vaccines & Microbicides Resource Tracking Working Group) has employed a comprehensive methodology to track trends in research and development (R&D) investments and expenditures for biomedical HIV prevention options. AVAC leads the secretariat of the Working Group, that also includes the International AIDS Vaccine Initiative (IAVI) and the Joint United Nations Programme on HIV/AIDS (UNAIDS).

More information about the growth and investment in the MPT field can be accessed in the 2017 IMPT Annual Report.

About the Authors
Fatima Riaz is the Program Coordinator for Research and Data Analytics at AVAC and has an MPH from Columbia University and a certification in Global Health Delivery from Harvard University. Her career started as a student health advocate in Pakistan where she founded and led a national polio advocacy campaign, and has since worked with the World Bank, the International Rescue Committee and UNICEF on diverse issues like WASH, violence prevention and maternal child health.

Kathryn Stewart is Deputy Director for CAMI/IMPT and has a Master’s in Public Policy from UC Berkeley with a special focus on maternal and child health. She also holds a BA in Politics and International Relations from Scripps College. Kathryn applies her 20-year experience in sexual and reproductive health prevention, policy, and research to coordinate a spectrum of projects aimed to advance the development and introduction of multipurpose prevention technologies (MPTs).