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Paving the Road for Rollout

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Jeanne Baron
Tuesday, June 18, 2019

Jeanne Baron is AVAC’s web editor and producer of Px Pulse.

This diverse set of some of the latest resources on PrEPWatch.org will help program implementers from a variety of contexts plan for the rollout and scale-up of PrEP. Added to the already extensive tools and resources available on PrEPWatch.org are: country-specific Situation Analysis for Kenya, South Africa and Zimbabwe; Health Care Providers’ Knowledge, Attitudes and Practices (KAP) Relevant to Oral PrEP Service Provision to AGYW in Zimbabwe; PrEP Costing Guidelines; The Common Agenda for the Dapivirine Ring, and The Dapivirine Ring Introduction Matrix.

Latest additions:

  • Country-specific Situation Analysis for Kenya, South Africa and Zimbabwe, have been developed to assess factors that are crucial to the expansion of PrEP rollout. Each report explores the strengths, challenges and progress to date on planning and budgeting, supply-chain management, the status of infrastructure and human resources places where people can obtain PrEP, and how people learn about PrEP and are supported in taking it.
  • Health Care Providers’ Knowledge, Attitudes and Practices (KAP) Relevant to Oral PrEP Service Provision to AGYW in Zimbabwe: This KAP study among health care providers in Zimbabwe explored questions about PrEP services for adolescent girls and young women. Health care providers serve as gatekeepers, encouraging or discouraging the use of new products or interventions. For example, providers report they have concerns about community backlash, or ambivalence about adolescent girls taking PrEP without their parents’ knowledge. They also report the need to balance concerns about adherence with the level of risk. The findings offer insights that can be applied to provider training and support. This report from Zimbabwe, and OPTIONS’ other KAP studies in Kenya and South Africa, may well be relevant to other places trying to enhance provider skills as part of the rollout of PrEP.
  • PrEP Costing Guidelines lay out the elements of estimating the cost of PrEP and how to adapt them appropriately and transparently for different objectives. These guidelines are written for individuals whose task it is to collect, evaluate and utilize cost data, and who may have differing levels of familiarity with economics.
  • Common Agenda for the Dapivirine Ring is for stakeholders working on aspects of planning for the introduction of the dapivirine vaginal ring, and summarizes key components for ring introduction, lists ongoing and planned efforts, and proposes next steps for streamlined and coordinated rollout.
  • The Dapivirine Ring Introduction Matrix shows the findings from a pilot discussion in Zimbabwe that explored how to integrate a new prevention product such as the ring into existing programs already focused on oral PrEP. The pilot discussion included policy makers, regulators, researchers, implementers and other partners. This resource explores where existing capacity could also support the rollout of the ring, and it suggests where additional planning and assistance would be needed. The matrix also highlights how ring introduction can strengthen other prevention efforts, especially oral PrEP.

These and other tools being developed by the OPTIONS Consortium (which is co-led by FHI360, AVAC and WITS RHI) can be used in the planning for future HIV prevention products as well. The OPTIONS Consortium is a major contributor to the growing body of technical resources for delivering PrEP options at scale in key countries, and complements work being done by many other efforts and partners, including the Prevention Market Manager project that looks to accelerate PrEP access and also improve the introduction of prevention options still in the research and development pipeline. These efforts dovetail with AVAC’s advocacy programs to close the multi-year gap from proven efficacy to access that has stalled the delivery of prevention in the real world.

Taken together this body of work found on PrEPWatch.org, can serve as case studies and templates to help implementers work swiftly, improve the quality of the delivery of prevention products and maximize their impact.