Motivating PrEP uptake and persistence amongst adolescent girls and young women in Mpumalanga, South Africa

Organization: Triggerise and the Institute of Health Programs and Systems (IHPS)




Study objective: Evaluate the effectiveness of a lucky draw using the Triggerise Tiko platform to increase PrEP initiation and persistence among adolescent girls and young women (AGYW).




Intervention description: The Triggerise Tiko application is a motivational and real-time technology based platform that makes connections across health services provision and demand while building ecosystems that encourage positive behaviours using nudges. The Tiko platform will be used to test the intervention which will include entering AGYW PrEP users into a lucky draw to motivate PrEP persistence. 


Behavioural economics principles will include present bias and social norms.



Evaluation description: This will be an individually randomised control trial. Eligible AGYW who register to use the Tiko platform will be randomly allocated to one of  two study arms:

  • No lucky draw (standard of care)  
  • Lucky draw 




Study outcomes: 

  • The primary outcome will be PrEP uptake within 1 month of screening
  •  The secondary outcome will be PrEP persistence measured at 3 months following uptake




Study site: PrEP-dispensing clinical sites led by nurses who have been trained in Nurse Initiated Management of Antiretroviral Therapy




Target population:

AGYW aged 15-24 who:

  • Test negative for HIV
  • Are screened by IHPS as belonging to high-risk groups and eligible for PrEP 
  • Have access to a mobile phone and are willing to use this phone as a means of identification during the study period
  • Are enrolled on the Tiko platform




Sample Size: We seek to enrol 4,312 AGYW with 2,156 per study arm at IHPS sites.




Duration: 15 months (includes a 2 months co-creation design phase)