(P261) Acceptability of and experiences with delivery of expedited partner therapy for STIs among adolescent girls and young women using oral PrEP in Johannesburg, South Africa

Background: Adolescent girls and young women (AGYW) utilizing oral pre-exposure prophylaxis (PrEP) for HIV prevention frequently experience high rates of sexually transmitted infections (STIs). The South African national guidelines recommend syndromic STI management at PrEP visits; however, this approach leads to missed opportunities for diagnostic management of asymptomatic STIs. To address this gap, we are conducting a prospective cohort study (ARISE) to assess implementation of same-day lab-based STI testing, treatment and expedited partner therapy (EPT) for STIs among AGYW using PrEP in Johannesburg, South Africa. Here, we report on initial EPT acceptance and experience with delivery to sexual partners.



Methods: Between February-December 2022, HIV-negative, non-pregnant, sexually active, cisgender AGYW aged 16-25 years who were interested in or already using PrEP underwent same-day STI testing for (C. trachomatis (CT) and N. gonorrhoeae (GC) by GeneXpert; T. vaginalis (TV) by OSOM. AGYW who tested STI+ received treatment per WHO guidelines and were eligible to participate in ARISE. At enrollment, all participants were offered EPT. Those who accepted engaged in counseling and role plays to support EPT delivery. Those who declined EPT were offered partner referral cards (standard of care). All participants returned one month later for repeat STI testing and structured interviews regarding experiences delivering EPT. We used descriptive statistics to report EPT acceptance and experiences with EPT delivery.



Results: Among 157 AGYW enrolled in ARISE, 67% reported one male sexual partner in the past three months; 77% had CT, 20% had GC and 19% had TV at enrollment, with 32% reporting STI-related symptoms. Of 140 (89%) participants who accepted EPT, 126 (90%) returned for the one-month visit. The majority (92%) reported successful EPT delivery to their primary partner. Participant experiences, perceived partner experiences, and impact of EPT delivery on the relationship are presented in the Figure. No incidents of physical violence were reported.

Conclusions: In this cohort of AGYW using PrEP, initial EPT acceptance was high, with a substantial proportion of AGYW reporting successful delivery of EPT to partners. As STI testing becomes increasingly available, EPT should be considered as part of a comprehensive STI treatment and prevention package for AGYW using PrEP.