Evaluation of Implementation Fidelity of Oral Pre-Exposure Prophylaxis Service in Public Health Facilities of Jimma Town, Oromia Regional State, Southwest Ethiopi

Abstract

Background: HIV/AIDS has already become one of the most serious threats to human life. In 2020, an estimated 37.7 million people were infected with the human immunodeficiency virus, with a global adult HIV prevalence of 0.7 percent. Female sex workers are at an extremely high risk of contracting the human immunodeficiency virus both globally and in Africa. HIV prevalence in Ethiopia is 0.9% and disproportionately af ects women, with a prevalence of 1.22% compared to 0.64% among males. Pre-exposure prophylaxis has emerged as an ef icient method of preventing human immunodeficiency virus infection in high-risk populations, particularly female sex workers and sero-discordant couples. Objective: To Evaluate Implementation Fidelity of Oral Pre-Exposure Prophylaxis Service in Public Health Facilities of Jimma Town, Oromia Regional State, Southwest Ethiopia,2021. Methods: A case study design with mixed methods was employed with the dimensions of Availability, Adherence and client satisfaction with a total of 46 indicators across the dimensions. A total of 333 exit interviews were conducted. Similarly, a document review of 365 clients' files, 17 in-depth interviews, and a resource inventory were conducted. Quantitative data were entered into Epi-Data (V4.0.64) and exported to SPSS (V26), and descriptive analyses were done by using frequency and percentages, while the qualitative data was transcribed, translated, summarized, and categorized into key thematic areas and was presented to complement the quantitative findings. Finally, the result of this evaluation was interpreted based on pre- determined judgment parameters (>=85 high, 75-84.9 medium, 60-74.9 low, and <=59.9 poor). Results: The evaluation revealed that the overall level of fidelity of implementation in public health facilities in Jimma Town was low (68.75%) as per the predetermined set of criteria. The availability of resources required to provide oral PrEP services was medium (78.6%). Provider adherence to the national implementation manual was low (69.4%), and client Satisfaction with the oral PrEP service of ered was Poor Level (55.9%). Conclusion: The overall level of implementation fidelity of the oral PrEP service in public health facilities was poor. Providers should comply with the implementation manual and refresher training, and the implementation manual, IEC/BCC materials, and STI test kit should be available