PrEP

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A home delivery of drugs in Jamaica, an innovative distribution model that is one of the latest adaptations in PrEP service delivery due to COVID-19.
A home delivery of drugs in Jamaica, an innovative distribution model that is one of the latest adaptations in PrEP service delivery due to COVID-19.
Credit: Jerome Burke, Jamaica AIDS Support for Life

Overview

Pre-exposure prophylaxis (PrEP) is the use of antiretroviral drugs by people who do not have HIV to prevent HIV acquisition. Studies have shown that oral PrEP, using oral tenofovir or tenofovir-containing regimens, significantly reduces the likelihood of acquiring HIV and, following the World Health Organization (WHO) guidelines, should be offered to those at substantial risk of HIV infection.

Per WHO recommendation, PrEP should be provided as part of a package of comprehensive prevention services that includes condom promotion, voluntary medical male circumcision, and structural interventions, aimed at influencing social, political, or economic environments, to reduce vulnerability to HIV infection. As a core component in this prevention package, oral PrEP (and new PrEP products as available) are vital interventions to prevent HIV acquisition.

HIV biomedical prevention research continues to evolve and innovate to support the development, introduction, and implementation of new forms of PrEP. For example, steps are already underway to plan for introduction and access for new prevention modalities that have been developed -- injectable cabotegravir and the dapivirine vaginal ring -- while also looking forward to the incorporation of other products. These additional biomedical prevention products will provide a wider range of choices that can be tailored to client needs, ultimately resulting in further reduction of new HIV infections through expanded access to HIV prevention options.

USAID Impact

USAID, through PEPFAR, supports innovative programming that ensures client-centered access to quality PrEP services by those who may benefit most, with a plan to contribute more than half of the ‘one million people on PrEP PEPFAR goal’ by September 2021. USAID works in close collaboration with host country governments, other U.S. Government agencies, multilateral and bilateral donors, the private sector, and implementing partners to provide support to PrEP scale-up through:

  • Technical assistance for program design, implementation, and monitoring and evaluation.
  • Technical assistance for policy, strategic, and operational plan development, including creation of PrEP clinical guidelines and standard operating procedures.
  • Service delivery, including knowledge expansion and demand creation, human resources for health, and innovations such as multi-month dispensing and decentralized drug dispensing.
  • Identification and sharing of best practices and support for regional learning exchange, including through the use of virtual multi-country platforms such as the Global PrEP Learning Network.
  • Development and implementation of demand creation strategies and materials as well as provider training for PrEP and new products.
  • Commodity procurement and logistics management, including forecasting and distribution.
  • Introduction and access research, including to inform implementation of new biomedical prevention products.

2020 Achievements

Since 2017, USAID has supported the implementation of PrEP.

  • As of September 2020, USAID has supported the initiation of more than 280,880 people on oral PrEP across 25 countries.
  • In FY20, despite COVID-19 related implementation challenges, USAID initiated 162,530 people on PrEP for the first time and supported a total of 198,263 people on PrEP.
  • Additionally, in FY20, USAID supported the launch of PrEP in four countries; USAID currently has 24 local partners implementing PrEP.
USAID has supported the initiation of more than 280,880 people on oral PrEP across 22 countries since October 2018
USAID has supported the initiation of more than 280,880 people on oral PrEP across 22 countries since October 2018
USAID supports a growing number of countries in initiating people on oral PrEP
USAID supports a growing number of countries in initiating people on oral PrEP

Additional Resources

PrEP Program Planning and Implementation Tools (see PrEPWatch)

Current USAID Partner Technical Assistance Support Activities

Last updated: June 01, 2021

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