HIV and gender-based violence (GBV) are syndemic. HIV epidemic control cannot be achieved without addressing gender inequality and GBV.

Post- exposure Prophylaxis

PEP is an essential service in GBV programming. Understanding the barriers, best practices, and lessons learned from existing interventions is necessary to improve USAID programs and increase PEP completion.

PEP uptake and adherence remain low among survivors of GBV. USAID programs monitor performance across the PEP cascade from presentation for post-sexual violence care to a final HIV test to assure the quality of timely care for survivors.

Graphic 1.1: Barriers to PEP adherence

  • Lack of Social Support
  • Stigmas associated with HIV and assault
  • Psychological trauma, stress and mental health issues
  • Side effects of PEP
  • Travel costs and financial barriers
  • Poor patient knowledge.

Graphic 1.2: Enablers of PEP adherence

  • Being reminded by family and peers
  • Encouragement from provider
  • Counseling and psychosocial support
  • Comprehensive post-rape care services
  • Monetary support for transport
  • Perpetrator known to be HIV-positive