Adherence

In addition to the starter kit, providing a sense of community can drive adherence and support.

Section Summary

1

Ambassador
Gatherings

2

Buddy
System

3

SMS
Reminder

4

Further
Incentives for refills

If you’re really strapped for cash and can only do one thing, do this:
SMS/Whatsapp reminder

1

Ambassador Gatherings

Ambassadors, if they’re open to it, can also become a constant drumbeat in a young woman’s life—a resource to reach out to with questions or a mentor for younger women. If your Ambassadors are open to such a thing, connect them with PrEP users via Whatsapp, especially if they’re in the same geographic areas.

Ambassadors can also invite current PrEP users to their events to help further spread the word. This gets PrEP users involved and gives them a feeling of accountability—they can’t forget to take their PrEP as they have ladies counting on them!

Consider creating a Whatsapp group among Ambassadors to share ideas for self-organized monthly gatherings. Schedule check-ins with Ambassadors to follow-up on any concerns and learnings from their interactions with users at the events.

Use any swag or merchandise to reward Ambassadors who are particularly involved and enthusiastic.

SUPPORTIVE FINDINGS FROM FORMATIVE RESEARCH

1. In South Africa, word of mouth can make or break you, as women truly believe in a product when they hear about it from people just like themselves, who are using it and for whom it is working.
2. Female empowerment has become culturally aspirational.


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2

A buddy system

A new behavior is easier to make stick when you have someone doing it with you. Encourage women to find a friend who also wants to protect herself from HIV and suggest they schedule their next tests together. Or, if the Ambassadors are open to it, use them as a resource to connect women in the community who are also PrEP users (obviously, only if they’ve given you permission to do so). If you build a digital presence such as a website or Facebook group, ladies can find each other through it.

If you are allowed to incentivize repeat visits to a clinic in your country (it depends on the regulations), you can also reward women who come in with their friends with T-shirts, stickers, airtime vouchers, or even an extra makeup bag.

SUPPORTIVE FINDINGS FROM FORMATIVE RESEARCH

1. “Ubuntu” is deep-seated in the psychology of a South African: This means that women are culturally predisposed to helping each other out.

3

Weekly reminder

Nothing helps you stay on track like getting a simple weekly reminder to take your pill each day. Ask women to sign up in clinics or online to receive weekly reminders via SMS or WhatsApp, and send them a discreet, empowering message each day to remind them to protect themselves.

We’ve written a guide on messages to help you get started, but ideally these messages should be in the vernacular and use local colloquialisms. We recommend starting a social media and/or email campaign to get women to submit their own messages. This allows women to get their reminders from women just like them—thus creating a continued sense of support and ownership, plus it puts a smile on their face.

Set some basic rules for the campaign, like using positive, empowering and/or humorous language, and not actually mentioning the pills outright to maintain discretion, and then let women get creative. Ask your Ambassadors to help get the campaign going!


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4

Further incentives for refills

Partner with popular local health and beauty brands targeting young women, to gain free samples to hand out at refill time and build upon that positive and victorious moment of knowing you’re HIV free (this should be executed infrequently, so that it feels like a delightful and unexpected moment as opposed to the norm). Look to partner with companies whose own advertising feels similar to V, and then show them the designs of the starter kits, advertising and other messaging to encourage working together toward this effort.

Begin to approach potential partner organizations through either their marketing departments or their CSR departments (if they are a larger company).

SUPPORTIVE FINDINGS FROM FORMATIVE RESEARCH

1. As a generation marked by scarcity, young people are willing to risk tomorrow for today.
2. Trends come and go very quickly, making novelty a necessity.

So, how do we do this?

Below you will find the key activities required to implement V. Under the V lite section, we’ve described hacks or adaptations for the more budget-conscious.

IF FUNDING IS TIGHT AND YOU'RE ONLY GOING TO DO ONE THING:

Empower the ambassadors to send weekly messages!

Ambassador gatherings

V Pro

  • Provide Ambassadors with stipends for promoting and hosting local gatherings of V users, which could include costs of catering, transportation and data usage.
  • Give them additional swag to hand out at events.

V Lite!

  • Don’t worry about giving out swag—shared community can be enough of a draw! Also consider tying the gathering to a free event women can go to together

Weekly reminder

V Pro

  • Designate a person / nurse / assistant at the clinics to enter V users into a database to receive texts. Get their name, phone number or What’sApp number, and what time they want to receive messages.
  • Let woman know that you will use some of the messages they come up with to remind women in their community to protect themselves. Consult a lawyer for specific language if necessary.
  • Create a unique hashtag for the campaign so you can track what messages women suggest and add them to your database.
  • Create a web form where people can submit messages (for instance, this could be a nicely designed Google form or something similar). This link can then be shared through social media or through digital advertising to collect messages from women for women.
  • Utilize your Ambassadors or engage an agency like Instant Grass in South Africa to use their network to seed the site with messages, and launch/advertise on social media.
  • Explore mass messaging services (like Simple Texting or Textedly) or hire a software developer to write a Twilio automation for ease of message dissemination. Twilio recently released an API for What’sApp in addition to Global SMS.

V Lite!

  • Nominate a clinic staff member (or Ambassador) to be in charge of supporting V users.
  • Create a poster with a Whatsapp number (a clinic can get a sim card just for this) where people can send messages of encouragement to women on V. Post it in waiting areas in clinics.
  • Create a Google Form and have the staff members copy and paste all the messages into the Google doc.
  • Once a week, the same person should pick one message and send it to the PrEP users on file (using the same SIM card to keep them anonymous).
  • If that feels like too much to ask Clinic Staff, ask your Ambassadors to create What’sApp groups amongst the women they support and send a daily reminder using the written messages. Make sure you cover any data costs.

Refill incentives

V Pro

  • Partner with local health-focused companies, such as insurance companies and pharmacies to set up point and reward programs for women picking up their V-branded PrEP prescription. For example, in South Africa, partner with Discovery Vitality to get users additional Vitality points when on PrEP (they already receive points for HIV tests).
  • Partner with lifestyle or beauty brands seeking to target this segment and get free samples of products to be handed out at refill time. Show them the design of V materials to encourage them to join forces with you.
  • Set up partnerships for non-product incentives. For example, offer a V-sponsored career workshop with 18twenty8, a local female empowerment group in South Africa.
  • If you are launching in the private sector, set pricing so that providing a Starter Kit to a woman in need can be an incentive. While the existing Starter Kit materials let women know that a portion of their purchase is used to supply Starter Kits for women in need, an excellent additional incentive would be to let women know how many refills they need to fill in order to fund an entire Starter Kit for someone in need. For example, perhaps every 4 refills buys a kit for a women in need.
  • Consider adding functionality to the loyalty card, or creating a digital loyalty program that can integrate with Point of Sale systems at pharmacies. Companies like Easy Loyalty in South Africa (http://www.easyloyalty.co.za/) can set this up for you.

V Lite!

  • Piggyback on existing point or loyalty programs at pharmacies by asking them to include picking up your V refill as an activity that earns points.
  • Have Ambassadors track refills and distribute incentives. For example, if a woman attends a monthly gathering with proof of her refill, the Ambassador could stamp or punch her Loyalty card. For every 3 stamps, she could earn swag or a simple gift. Make sure to supply Ambassadors with these items if you are taking this approach.

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