PE05.01
Share

Recruiting adolescent girls and young women into the MTN-034 Study: lessons learnt from the Kampala and Johannesburg sites

Title
Presenter
Authors
Institutions

BACKGROUND: The MTN 034/REACH is an 18 month cross-over study of daily oral PrEP and monthly dapivirine vaginal ring safety and preferences, recruiting adolescent girls and young women (AGYW) aged 16 to 21 years across 4 African sites; Uganda, Zimbabwe, Johannesburg and Cape Town. AGYW are usually study naïve, undecided about their sexual and reproductive health care and fear peer and community judgment; hence effective recruitment strategies are critical. Recruitment involves presenting potential participants with adequate information about the study to help establish interest and trust, willingness to participate and eligibility assessment. We describe the strategies employed at the Kampala and Johannesburg sites to recruit AGYW in to the MTN-034 study, share challenges faced and lessons learned.
METHODS: Memorandums of Understanding (MoUs) were established with different stakeholders prior to sensitization and recruitment. Contacts for mobilization were established with different partners and communities. Peer contacts in Reproductive Health centers referred potential participants to the site clinic. Sensitization about the study was conducted in different areas and activity records kept in pre-screening logs. A pre-screening/recruitment checklist was used to determine presumptive eligibility in the community and for continued pre-screening in the clinic. Pre-enrollment sessions were conducted to address questions and concerns before enrollment.
RESULTS: A total of 129 AGYW were enrolled out of 623 prescreened (Table 1). In Kampala ' contacts were made with 74 stakeholders (religious, local leaders and parents/guardians community partners) and recruitment spots were established to mobilize AGYW. Similarly, In Johannesburg - contacts were made with 50 stakeholders, ward councils, community health facilities and with Adolescent Friendly Clinics.
Table 1: Recruitment statistics and challenges faced in AGYW recruitment (Jan 2019 to Feb 2020)

Clinical Research Site (CRS)KampalaJohannesburg
Sensitized755870
Pre-screened322301
Presumptively eligible
Minors (16-17)
Young women (18-21)
235
59
176
226
51
175
Presented at clinic
Minors
Young women
148
40
108
134
36
98
Challenges faced at both sites
Some minors have no parents or guardian
Difficulty locating and identifying authentic parents/guardians to consent
Some minors were not ready to disclose to their parents that they are sexually active
Lack of or poorly working cell phones
Limited awareness/ knowledge of PrEP
Rumors and misconceptions about research in communities
Many AGYW are still in school, tertiary institutions or employed
Fear of the unknown (research and study products)

CONCLUSIONS: Successful recruitment of AGYW requires a multipronged approach with community stakeholders, parents/guardians and the young women themselves to achieve accrual within specified timelines.