TY - JOUR
T1 - Health system adaptations and considerations to facilitate optimal oral pre-exposure prophylaxis scale-up in sub-Saharan Africa
AU - Were, Daniel K.
AU - Musau, Abednego
AU - Atkins, Kaitlyn
AU - Shrestha, Prakriti
AU - Reed, Jason
AU - Curran, Kelly
AU - Mohan, Diwakar
N1 - Funding Information:
DKW and AM received partial support through the Jilinde project in Kenya, which is funded by the Bill & Melinda Gates Foundation under investment number INV-007340. The donor did not play any role in the conceptualisation and writing of this Review. The views expressed in this manuscript are those of the authors and do not necessarily represent the opinions of the Bill & Melinda Gates Foundation.
Publisher Copyright:
© 2021 Elsevier Ltd
PY - 2021/8
Y1 - 2021/8
N2 - Following WHO's 2015 recommendation, countries in sub-Saharan Africa have progressively scaled up oral pre-exposure prophylaxis (PrEP) as part of combination HIV prevention. PrEP has potential to significantly reduce new HIV infections in sub-Saharan Africa if it is widely available, accessible, and effectively used. 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, resulting in suboptimal coverage among priority groups at higher risk of HIV acqusition. Using the WHO health system building blocks framework, this Review synthesises literature on essential considerations for PrEP scale-up in sub-Saharan Africa, highlighting the importance of health system adaptability and responsiveness.
AB - Following WHO's 2015 recommendation, countries in sub-Saharan Africa have progressively scaled up oral pre-exposure prophylaxis (PrEP) as part of combination HIV prevention. PrEP has potential to significantly reduce new HIV infections in sub-Saharan Africa if it is widely available, accessible, and effectively used. 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, resulting in suboptimal coverage among priority groups at higher risk of HIV acqusition. Using the WHO health system building blocks framework, this Review synthesises literature on essential considerations for PrEP scale-up in sub-Saharan Africa, highlighting the importance of health system adaptability and responsiveness.
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U2 - 10.1016/S2352-3018(21)00129-6
DO - 10.1016/S2352-3018(21)00129-6
M3 - Review article
C2 - 34265282
AN - SCOPUS:85111508866
SN - 2352-3018
VL - 8
SP - e511-e520
JO - The Lancet HIV
JF - The Lancet HIV
IS - 8
ER -