MOSAIC
Maximizing Options to Advance Informed Choice for HIV Prevention
Maximizing Options to Advance Informed Choice for HIV Prevention (MOSAIC) is a five-year (2021-2026) global project funded by the US President’s Emergency Plan for AIDS Relief (PEPFAR) through the US Agency for International Development (USAID) to help women prevent HIV by accelerating introduction and scale-up of new and emerging biomedical prevention products.
- For a two-page overview of MOSAIC, click here
- For an outline of MOSAIC’s work across the product introduction framework, click here
- To subscribe to MOSAIC’s quarterly newsletter, click here
The CATALYST Study
Catalyzing Access to New Prevention Products to Stop HIV (CATALYST) is MOSAIC’s flagship product introduction study. The study will provide and assess an enhanced service delivery package that includes oral PrEP, PrEP ring, and injectable cabotegravir. The package of products and services for PrEP will be provided to women at PEPFAR/USAID delivery sites in Kenya, Lesotho, South Africa, Uganda, and Zimbabwe. The CATALYST study will also use quality improvement methods to refine the program and identify a core package for delivering PrEP choice. Click here for access to the protocol and study implementation materials.
More Resources
Global Tools and Resources
PrEP Ring for Adolescent Girls and Youth Women: Summary of research findings
This brief outlines findings from a recent study which has published critical new data on use of the dapivirine vaginal ring (PrEP ring or ring) among adolescent girls and young women in eastern and southern Africa, offering evidence that the ring is safe, effective, and highly acceptable.
PrEP Ring Safety Data in Adolescent Girls and Youth Women (AGYW)
This slide deck presents emerging evidence to support conversations on expanding pre-exposure prophylaxis (PrEP) ring access for adolescent girls and young women (AGYW) in policy and programmatic rollout.
PrEP for Pregnant and Breastfeeding People: Advocacy, Policy, and Programmatic Tools
The PrEP for Pregnant and Breastfeeding People Package is designed for use by policy makers, program implementers, and healthcare workers to expand provision of PrEP to PBFP. The evidence-informed materials are designed to be adapted to reflect local context and priorities, national policy and guidelines, and implementation context surrounding provision of PrEP to PBFP.
MOSAIC – PrEP Site Implementation and New Product Readiness Assessment Tool
This tool is intended to provide insight into the current state of PrEP services and to identify critical barriers and facilitators to PrEP implementation. Additionally, this tool is designed to inform preparations for new PrEP product introduction (CAB PrEP, PrEP ring, or both) according to national priorities.
Training: Using a Trauma-Informed Approach in Data Collection
These materials are designed to support study teams to apply a trauma-informed approach to data collection in order to minimize harm to both study participants and data collectors, and to aid in their paths to recovery.
Global Mapping of PrEP Ring Implementation Research and Programmatic Pilots
This analysis provides an overview of the 13 introduction studies that include the PrEP ring as one of the PrEP products under investigation alongside oral PrEP and/or CAB PrEP as of November 2023. All of the PrEP ring studies are conducted in Sub-Saharan Africa and focus primarily on adolescent girls and young women (AGYW) as well as female sex workers (FSW) and women engaged in transactional sex.
Global Acute HIV Infection Algorithm Job Aids
These job aids can assist providers in ruling out HIV infection by offering guidance through three steps: HIV testing, HIV recent exposure assessment: determining need for PEP instead of PrEP, and acute HIV infection assessment. Click here for more.
Product Registration
For an overview of the product registration process, click here.
PrEP-it 2.1
A new version of PrEP-it is now live at https://PrEPitWeb.org. PrEP-it is designed to support planning, implementation, monitoring and evaluation of PrEP delivery. Key features of PrEP-it include setting national and subnational targets, estimating costs and impact associated with targets, monitoring PrEP initiation, and forecasting drug supply needs.
Application of PrEP-it in Kenya
This brief describes how PrEP-it was used to inform commodity forecasting for PrEP products in Kenya and highlights lessons learned.
PrEP Product Implementation Plan Template
This adaptable template can be utilized by national governments, their ministries, and relevant stakeholders involved in rolling out new pre-exposure prophylaxis. It contains vital components of the value chain and outlines considerations for countries wishing to layer on these new PrEP products in existing PrEP programs. Please note that countries wishing to introduce new PrEP products through pilot or demonstration studies will require a different approach, including development of a research protocol.
Template Guidelines for PrEP
These adaptable guidelines (in English, French and Spanish) can be used to support the development and adoption of national guidelines that align with WHO PrEP guidance, and include prompts for national-level consideration during the guideline adaptation process. The guidelines cover daily oral PrEP, event-driven PrEP, the PrEP vaginal ring, and injectable CAB for PrEP.
HIV Prevention Ambassador Training Package and Toolkit
The HIV Prevention Ambassador Training Package and Toolkit was created to prepare potential and current PrEP users to be leaders – or “Ambassadors” – in the rollout of PrEP for HIV prevention in their communities.
HIV Prevention User Journey Tool
This tool was developed to support adolescent girls and young women to explore methods that would align with their lifestyle, needs and personal preferences; and support healthcare providers to provide informed counseling based on client needs.
Post-Exposure Prophylaxis (PEP) Policy Synthesis Brief
This brief summarizes the PEP policy landscape, how to address barriers to policy and implementation, and provides recommendations to increase PEP uptake as part of HIV prevention. While it focuses on countries within the MOSAIC consortium, the findings are broadly applicable for ministries of health, implementing partners, providers, and potential PEP users alike.
Background Resources on Cabotegravir (CAB) for PrEP
This reference document lists key resources on research and evidence for CAB for PrEP.
Building Community Acceptance for PrEP Use among Adolescent Girls and Young Women (AGYW) in Sub-Saharan Africa
These materials from a MOSAIC Action Tank held in 2022 examine which community influencers impact PrEP use among AGYW and the behavioral determinants that influence their support of AGYW PrEP use, as well as identify promising community acceptance interventions that directly address these determinants for adaptation and evaluation under MOSAIC or other PrEP-focused initiatives.
Provider Support of PrEP Use Among Adolescent Girls & Young Women: A review of learnings on provider behavior to inform services in multi-method markets
This report aims to collate the key insights, lessons learned, strategies, and examples from past and current programs and studies that focus on providers of PrEP for AGYW. It aims to uncover both what is known and what opportunities exist to further understand provider behavior to inform multi-method service provision in a rapidly expanding PrEP market.
Country-Specific Analyses
Value Chain Situation Analyses
Situation analyses are an initial step in supporting national planning for the introduction and scale-up of PrEP methods.
South Africa PrEP Implementation Study Mapping Analysis
This analysis aims to investigate which questions will/will not be addressed by the current slate of ongoing or planned implementation science to inform decisions about investments in additional research (if needed) and provide an understanding of when insights across key questions will become available to help inform the rollout planning for the new PrEP methods in South Africa.
PrEP ring stakeholder conversations in Eswatini, Kenya, Lesotho, Namibia, Nigeria, South Africa, Uganda, Zambia and Zimbabwe
These country-level analyses share key stakeholder perceptions of the ring in each country and are the product of consultations led by WHO, IPM, and MOSAIC during the period December 2021 – March 2022.
Building Community Acceptance for PrEP Use among Adolescent Girls and Young Women in Sub-Saharan Africa
In 2022, MOSAIC held an action tank in Zambia called Building Community Acceptance for PrEP Use among Adolescent Girls and Young Women in Sub-Saharan Africa. Click here to view the materials that emerged from those discussions.
Formative Research on CAB for PrEP in Eswatini
Click here to view a report summarizing end-user perspectives on CAB for PrEP in Eswatini.
Private Sector Market Assessment: Eswatini
This market assessment explores the opportunities and barriers to leveraging private sector channels to expand access to new and existing pre-exposure prophylaxis (PrEP) methods, including oral PrEP, the dapivirine vaginal ring (PrEP ring), and long acting cabotegravir (CAB PrEP) in Eswatini.
Eswatini Dapivirine Ring Messaging & Positioning Report
The Busara Centre for Behavioral Economics carried out market research on communication strategies for the PrEP ring in Eswatini in partnership with IPM and FHI 360 in 2021-2022. The resulting report recommends 12 communication strategies for positioning the PrEP ring in Eswatini, along with a description of the Eswatini context and population segments likely to take up the ring.
Demand Generation
PrEP Category Positioning Strategy
A positioning strategy is an important marketing tool intended for use by implementers who develop national communication strategies and demand generation campaigns for PrEP. Learn about and access resources related to MOSAIC’s positioning strategy for adolescent girls and young women here.
PrEP Communication and Demand Generation Strategy Template
This template is designed to provide an overview and outline of the different sections of a national communication or demand generation strategy. It is intended for demand generation, social behavior change (SBC), or communication focal points to apply in countries developing new PrEP or HIV prevention strategies or updating their strategies with new PrEP options.
CAB PrEP Compendium of End User Insights
Understanding end users is a critical first step to establishing effective communication and informing program delivery. This document intends to help inform development and updating of national HIV prevention, combination prevention, and PrEP communication and demand generation strategies, campaigns and plans with CAB-specific insights. It can also be shared with program implementers to inform communication and program delivery for CAB PrEP and method choice.
Drug Resistance Monitoring
MOSAIC HIV Drug Resistance Monitoring Program
MOSAIC’s HIV Drug Resistance (HIVDR) Monitoring Program monitors HIVDR in PrEP seroconverters in project-based and national roll-out programs in sub-Saharan Africa. The HIVDR Monitoring Toolkit can assist ministries of health, project implementers and policy makers develop HIVDR monitoring strategies and support the collection and testing of blood samples for HIVDR testing.
Gender and Youth
To learn more about MOSAIC’s Gender and Youth Strategy, click here.
The NextGen Squad
The MOSAIC NextGen Squad is a team of paid youth advocates under the age of 30 from Eswatini, Kenya, Lesotho, Namibia, Nigeria, South Africa, Uganda, Zambia, and Zimbabwe. This dynamic group of young people shape, influence, and participate in a variety of MOSAIC project activities. They ultimately hold MOSAIC accountable as the project aligns its plans, actions, monitoring and evaluation, and learning efforts to be responsive to young people’s needs, preferences, and lived experiences; include the diversity of AGYW; and meaningfully engage young people in research and research utilization. To learn more about the NGS’ quarterly webinar series, click here