Scaling-up PrEP Delivery in Sub-Saharan Africa: What Can We Learn from the Scale-up of ART?

Current HIV/AIDS Reports
Gabrielle O'MalleyKenneth K Mugwanya

Abstract

Clinical trials have found that PrEP is highly effective in reducing risk of HIV acquisition across types of exposure, gender, PrEP regimens, and dosing schemes. Evidence is urgently needed to inform scale-up of PrEP to meet the ambitious WHO/UNAIDS prevention target of 3,000,000 individuals on PrEP by 2020. Successful models of delivering HIV services at scale evolved from years of formal research and programmatic evidence. These efforts produced lessons-learned relevant for scaling-up PrEP delivery, including the importance of streamlining laboratory tests, expanding prescription and management authority, differentiating medication access points, and reducing stigma and barriers of parental consent for PrEP uptake. Further research is especially needed in areas differentiating PrEP from ART delivery, including repeat HIV testing to ensure HIV negative status and defining and measuring prevention-effective adherence. Evidence from 15 years of ART scale-up could immediately inform a public health approach to PrEP delivery.

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Citations

Oct 1, 2020·Journal of the International AIDS Society·Katrina F OrtbladJared M Baeten
May 15, 2020·Nature Medicine·Elizabeth M Irungu, Jared M Baeten
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Jan 26, 2021·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Fernandos K OngollyGabrielle O'Malley
Aug 29, 2021·AIDS and Behavior·Collin MangenahFern Terris-Prestholt
Sep 9, 2021·Journal of the International AIDS Society·Elizabeth M IrunguUNKNOWN Partners Scale-Up Project Team
Dec 16, 2021·Current HIV/AIDS Reports·Neeraja BhavarajuKristine Torjesen

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Clinical Trials Mentioned

NCT03593629

Software Mentioned

PEFPAR

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