Health System Adaptations and Considerations to Facilitate Optimal Oral Pre-exposure Prophylaxis Scale-up in Sub-Saharan Africa

Countries in sub-Saharan Africa have progressively scaled up oral PrEP as part of combination HIV prevention. Initial scale-up efforts have generated progress, drawing lessons from existing HIV interventions, such as antiretroviral therapy and biomedical prevention. However, beset by unprepared health systems, scale-up has been slow. This review synthesises literature on essential considerations for PrEP scale-up, highlighting the importance of health system adaptability and responsiveness.