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Demonstrate: Invest in an oral PrEP-driven paradigm shift

Even as funders and governments have been slow to define and implement a comprehensive suite of PrEP demonstration projects, individuals living with HIV and HIV negative people living in contexts and communities where they feel their prevention needs are unmet, have begun to demand PrEP. They have initiated a dynamic, even revolutionary dialogue about the right to this life-saving strategy.

Planned, ongoing and completed demos

The discussion has moved far beyond the boundaries of the relatively-small HIV prevention advocacy sphere, and the even smaller sphere of biomedical prevention research advocacy. It is part of a wide-ranging conversation about the right to sex without fear or judgment and about ways that HIV-positive and HIV-negative people can share agency and responsibility as they negotiate their respective options for using ARVs for prevention.

In other words—PrEP has become a cause and a rallying cry. But it is not yet a reality. And that is why our key recommendation for 2015 is a call to funders, national governments, implementing agencies and civil society groups working across identities and issues to invest time and money in an oral PrEP-driven paradigm shift.

It is time for scale-up to keep up with this momentum. Both because daily oral PrEP can save lives today and because learning how to implement this strategy will lay the groundwork for new prevention options, especially ARV-based microbicides, if and when they are demonstrated to be efficacious in clinical trials.

  • Implement large-scale pilots linked to national programs for oral PrEP.
  • Include a PrEP recommendation for women and adolescents in the next revision of the WHO Guidance on ARVs.
  • Plan and program around roll-out of other ARV-based prevention options.
PrEP projects planned in Africa 2015
Read the full Demonstrate section in AVAC Report 2014/15.