Addressing the Need for a Preexposure Prophylaxis Monitoring and Evaluation Implementation Guide: Experience From Zambia

28 March 2023

The HIV care continuum comprises well-defined steps and indicators. In contrast, indicators along the preexposure prophylaxis (PrEP) cascade are still in the early stages of implementation. Monitoring and evaluation (M&E) of PrEP services is critical to optimizing PrEP uptake and adherence during periods of HIV risk. We provide an overview of global indicators for PrEP, describe the development process and outcomes of Zambia’s 2022 National Pre-Exposure Prophylaxis (PrEP) Program Monitoring & Evaluation Implementation Guide, and discuss the guide’s implications for other countries in sub-Saharan Africa.

Featured Resources

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Pre-Exposure Prophylaxis Implementation Gaps among People Vulnerable to HIV Acquisition: A cross-sectional analysis in two communities in western Kenya, 2021–2023

This article, from Journal of the International AIDS Society, examines PrEP awareness, uptake, and persistence among participants enrolling into an HIV incidence cohort in Kenya.

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Initiation and Continued Use of Oral Pre-Exposure Prophylaxis among Pregnant and Postpartum Women in South Africa (PrEP-PP): A demonstration cohort study

This article from The Lancet HIV describes the results of a demonstration study in South Africa, PrEP-PP, to integrate oral PrEP provision into public clinics offering antenatal and postnatal care to pregnant and lactating people.

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Acceptability of Six-Monthly PrEP Dispensing Supported with Interim HIV Self-Testing to Simplify PrEP Delivery in Kenya: Findings from qualitative research

This article from BMC Health Services Research discusses the results of a pilot in Kenya to explore the acceptability of dispensing PrEP twice a year, with interim HIV self-testing, versus quarterly, with clinic-based HIV testing.

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Dynamic Choice HIV Prevention with Cabotegravir Long-acting Injectable in Rural Uganda and Kenya: A randomised trial extension

This article from The Lancet HIV discusses the results of the SEARCH dynamic choice study conducted in Kenya and Uganda, comparing outcomes between one group offered a choice between oral PrEP, post-exposure prophylaxis, and cabotegravir for PrEP, and a second group receiving the standard of care.

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Adolescent Girls and Young Women Overcoming Adherence Challenges with Vaginal and Oral PrEP Use: A longitudinal qualitative study from a crossover trial in South Africa, Uganda, and Zimbabwe

This article from AIDS and Behavior explores South African, Ugandan, and Zimbabwean adolescent girls and young women’s experiences in a crossover trial of two HIV prevention products: daily oral PrEP and a monthly dapivirine vaginal ring.

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Access Workbook for Cabotegravir for PrEP, Dapivirine Vaginal Ring, and Lenacapavir for PrEP

This workbook, compiled by the Global Fund, contains key access information relating to cabotegravir (CAB) for PrEP, the dapivirine vaginal ring (DVR), and lenacapavir (LEN) for PrEP for all lower and middle income countries, including eligibility for Global Fund support, PEPFAR support status, regulatory status of CAB for PrEP and the DVR, access to non-profit…

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Expanding Access to Lenacapavir

This United Advocates Network Call, titled Breaking New Ground: Expanding Access to Lenacapavir— Lessons from Dolutegravir and the Future of HIV Prevention, brought together global health experts, community advocates, and civil society organizations to discuss the challenges and opportunities in ensuring equitable access to Lenacapavir.

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Role of HIV Self-testing in Strengthening HIV Prevention Services

This article from The Lancet HIV examines the potential role of HIV self-testing (HIVST) in achieving HIV prevention goals by looking at trials of use of HIVST with prevention tools such as pre-exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP), and voluntary medical male circumcision (VMMC).

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We Choose: Adolescent girls and young women’s choice for an HIV prevention product in a cross-over randomized clinical trial conducted in South Africa, Uganda, and Zimbabwe

This article from PLOS One describes decision-making and product choice amongst adolescent girls and young women in South Africa, Uganda, and Zimbabwe when given a choice between oral PrEP and the dapivirine vaginal ring as part of the REACH crossover study.

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“I was given PrEP, but had no privacy”: Mystery shopper perspectives of PrEP counseling for adolescent girls and young women in Kisumu County, Kenya

This article from PLOS One describes the results of a study using adolescent girls and young women as “mystery shoppers” in Kenya to identify barriers to effective PrEP service provision.