HIV PrEP services study

A randomized trial (co-authored by UW SON professor Dr. Pamela Kohler) evaluated the effectiveness of using patient actors to role play counseling for PrEP (pre-exposure prophylaxis) services provided to adolescent girls and young women in Kenya – a population disproportionately affected by HIV in the region. 

After a 2-day training intervention that included adolescent health, PrEP guidelines, values clarification, and communication skills; intervention providers role-played with trained actors. Control facilities received standard national training. 

“It was important to have a safe space to practice discussions about HIV with young women, so that providers could feel more confident with sensitive topics and ensure that their personal values weren’t negatively affecting young people seeking care,” said Kohler. “The providers were exceptionally receptive to feedback from the actors and their peers.” 

At the end of the study, both the intervention and control facilities were assessed using what you might know as “secret shopping” or “mystery shopping.” Trained actors presented to clinics portraying young women requesting PrEP services according to case scripts, then documented their care experiences with study staff. The actors didn’t know whether the facilities they attended had received the training, and the providers did not know they were caring for actors. 

Six African women pose in front of a clinic

Patient actors from the randomized trial at a health service setting in Kenya.

The difference in quality of service was astonishing. 

Providers who had worked with the actors scored better across the board for both adherence to national guidelines and communication skills. Quality at the control sites received a mean score of 58%. At sites where providers worked with the actors? 74%.  

That kind of impact could have far-reaching implications for improving HIV prevention not only for adolescent girls and young women in the region, but also globally and for other underserved populations in need of PrEP or other health services.  



Read the full study results: